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1 <br />U.S. Postal Service,. <br />CERTIFIED MAILT. RECEIPT <br />r3 r-3 (Domestic Mall Only, No insurance Coverage Provided) <br />MIM <br />mIm <br />r` ' r`- .p , <br />trr Ir l <br />lti rti Postage $ <br />Certified Fee <br />M m Postmark <br />SENDER: COMPLETE THIS SECTION COMPLETE THIS SECTI <br />¦ Complete items 1, 2, and 3. Also complete <br />item 4 if Restricted Delivery Is desired. <br />¦ Print your name and address on the reverse <br />so that we can return the card to you. <br />¦ Attach this card to the back of the mailpieoe, <br />or on the front if space permits. <br />1. Article Addressed to: <br />Mr. and Mrs. Fred Dodge <br />11992 Weld County Road # 18 <br />Fort Lupton, CO 80621 <br /> <br />O O Return Receipt Fee <br />' <br />O O <br />Here <br />(Endorsement Required) <br />O O Restricted Delivery Fee <br />-- O O (Endorsement Required) <br />_ ul u7 T Q <br />/ <br />?-7 <br />r1J rU , <br />-- ..n . .? Mr. and Mrs. Fred Dodge <br />°O °O 11992 Weld County Road # 18 •-----------•---- <br />r` r` Fort Lupton, CO 80621 <br />A. Signature <br />I <br />X 0 Agent 1 <br />0 Addressee i <br />B. Received by (Piing Name) C. Date of Delivery <br />D. Is delivery address ddWent from item 1? 0 yes <br />H YES, enter delivery address below: 0 No <br />I <br />I <br />3. Service.Type i <br />ACertified Mail 0 Express Mail <br />0 Registered WRetum Receipt for Merchandise i <br />0 insured Mail b C.O.D. 1 <br />4. Restricted Delivery? (Extra Fee) p yes <br />2. Article Number <br />7006 2150 0003 6779 7330 <br />(riansfer from service label) <br />Ps Form 3811, February 2004 Domestic Return Receipt 102595.02-M-1540!