2009-11-24_REVISION - C1984067 (2)

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■ Complete items 1, 2, and 3. Also complete A. Item 4 if Restricted Delivery Is desired. X ■ Print your name and address on the reverse so that we can return the card to you. g ■ Attach this card to the back of the mailpiece, or on the front if space permits. 1- Article Addressed to: `William Denam 5111 Lyda Lane Colorado Springs, ❑ Agent by (Printed Name) I C. Date of Delivery D. Is delivery ad If YES, enter ❑ Yes ❑ No Y U 4 CO 80904 -1009 1 3. ServlceType ❑ CadMW Mail ❑ Opess Mall I ❑ Registered ❑ Return Receipt for Merchandise ❑ Insured Mail ❑ C.O.D. 4. Restricted Delivery? (Extra Fee) ❑ Yes 2. Article Number — ' (Transfer from servicerabeo 7005 0 390 2002 8281 8380 , Ps Form 3811, February 2004 Domestic Return Receipt 102595.02 -M -1540 Po stal �° ( RECEI ,-1 Co ti ' OFFICIAL Us CO o Postage: C3 Certified Fee: (End Return Receipt Fee: /� °, �y �Q44 ��` _$2-.80 ` C3 (End M C3 Postag Total P e g & Fees; ; �$5,54,� ul Total Postage & Fees l i C3 Se. William Denam or 5111 Lyda Lane c" Colorado Springs, CO 80904 -1009 ■ Complete items 1, 2, and 3. Also complete A. Item 4 if Restricted Delivery Is desired. X ■ Print your name and address on the reverse so that we can return the card to you. g ■ Attach this card to the back of the mailpiece, or on the front if space permits. 1- Article Addressed to: `William Denam 5111 Lyda Lane Colorado Springs, ❑ Agent by (Printed Name) I C. Date of Delivery D. Is delivery ad If YES, enter ❑ Yes ❑ No Y U 4 CO 80904 -1009 1 3. ServlceType ❑ CadMW Mail ❑ Opess Mall I ❑ Registered ❑ Return Receipt for Merchandise ❑ Insured Mail ❑ C.O.D. 4. Restricted Delivery? (Extra Fee) ❑ Yes 2. Article Number — ' (Transfer from servicerabeo 7005 0 390 2002 8281 8380 , Ps Form 3811, February 2004 Domestic Return Receipt 102595.02 -M -1540