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2009-05-09_REVISION - C1981048
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2009-05-09_REVISION - C1981048
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Entry Properties
Last modified
8/24/2016 3:46:20 PM
Creation date
5/13/2009 9:52:28 AM
Metadata
Fields
Template:
DRMS Permit Index
Permit No
C1981048
IBM Index Class Name
REVISION
Doc Date
5/9/2009
Doc Name
Certified Return Receipt (Termination of Juridiction)
From
Landowners
To
DRMS
Type & Sequence
SL6
Email Name
KAG
Media Type
D
Archive
No
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¦ 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 mailpiece, <br />or on the front if space permits. <br />1. Article Addressed to: <br />Budd John & Elizabeth <br />1601 S. Lansing St ' <br />Aurora, Co 80012 i <br />A. SigTn re <br />X ? Agent <br />? Addressee <br />B. Receiv by (Printe Name) Date of Delivery <br />D. Is delivery address different from item 1? ? Yes <br />If YES, enter delivery address below: ? No <br />3. Service Type <br />rtified Mall ? Express Mail <br />Registered ? Return Receipt for Merchandise <br />? Insured Mail ? C.O.D. <br />1 4. Restricted Delivery? (Extra Fee) ? Yes <br />2. Article Number 7003 1680 0000 6431 4511 <br />(Transfer from service label) <br />PS Form 3811, February 2004 Domestic Return Receipt 102595-02-M-1540 <br />a. <br />¦ Cc;".mplete items 1, 2, and 3. Also complete <br />i%, m 4 if Restricted Delivery is desired. <br />¦ W int your name and address on the reverse <br />s( , -) that we can return the card to you. <br />¦ KAach this card to the back of the mailpiece, <br />o r on the front if space permits. <br />1. Article Addressed to: <br />i <br />Manuel Balderas <br />2732 Weld County Rd #27 <br />Fort Lupton, Co 80621 <br />A. Signat <br />t <br />El Agent <br />X ? Addressee <br />B Received by (Printed Name) C. rDate (off Delivery <br />q,e ( (/r t / J / r0 er/ , <br />D. Is delivery address different from item 1? ? Yes <br />If YES, enter delivery address below: ? No <br />ified Maii ? 6cpress Mail <br />S Egistered Type <br />? ? Return Receipt for Merchandise <br />? Insured Mail ? C.O.D. <br />4. Restricted Delivery? (Extra Fee) <br />? Yes <br />2. Article Number <br />7006 3450 0000 4880 0780 <br />(Transferr from rom service label) <br />PS Form 3811, February 2004 Domestic Return Receipt <br /> <br />102595-02-M-1540
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