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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 />Geneva Rogers <br />P.O. Box 867 <br />Limon, CO 80828 <br />A. Signature <br />B. Received by ( <br />13 <br />C. Date of Delivery <br />y-er\e ,c,. / oc, et 5 1 fn-13- 9 <br />D. Is delivery address dif rent from Rem 1 ? ? Yes <br />If YES, enter delivery address below: ? No <br />3. Se ice Type <br />WCertifled Mail ? Express Mail <br />? Registered ? Return Receipt for Merchandise <br />? Insured Mail ? C.O.D. <br />4. Restricted Delivery? (Extra Fee) ? Yes <br />Z. Article Number --- <br />(Tiansfer from service labs 7008 0150 0002 1120 3 714 <br />S Form 8811, February 2004 Domestic Return Receipt <br /> Postal Service,. <br /> CERTIFIED MAIL,,., R ECEIPT <br />S (Domestic Mail Only; No Insuranc e Covera <br />P <br />id <br /> ge <br />rov <br />ed) <br /> • <br />Rl <br />0 !.I <br /> <br />r-1 Postage $ $1.05 0780 <br />rR <br /> Certified Fee $2.80 0(s <br />r1i <br />p <br /> <br />O <br />Return Receipt Fee <br /> <br />(Endorsement Required) <br /> <br /> <br />0.00 <br /> <br />Postmark <br />Here <br />C3 <br />. Restricted Delivery Fee <br />(Endorsement Required) <br />$4.50 <br />0 <br />rr-1 Total Postage $ Fees $8.35 10/08/2009 <br />E3 <br /> <br />CD Sent To <br />E3 Street Apt. tJO.j -•-------•--?°-•--..._-- <br />or PO Box No. <br /> City, State, ZIP +4 - °'°°-'°°•-- '°' .---.' <br /> PS Form :3800, August 2006 S <br />R <br /> ee <br />everse for InsIr uctions <br />102595-02-M-1540