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Willtis Company, Inc. McEndaffer Mine <br />M-2010-034 County Adequacy placement receipt. <br />R Complete hams 1, 2, and 3. Also complete <br />Item 4 if Restricted Delivery is desired. <br />¦ Print your name and address on the reverse <br />i --so that Wa%ho niturn thetard toym.- <br />¦ Attach this card to the back of the mailpieos, <br />or on the front ff space permits. <br />1. Article Addressed to: <br />wACIZ (201-,x, Cler L <br />T 71144- 7 6*44b . <br />9i0 / O <br />A Signet ire x eAgeM <br />0 Addressee <br />Ea (pdpp9c(ygti?4w ?' O. Date of Deliv>3ry ' <br />D. is delivery address different from item 12 13 Yes <br />If YES, enter delivery address below. O No <br />3. Service Type <br />0t;; tified Mall ? Enptess Mall <br />? Registered -PR Ytum Receipt for Merchandise <br />0 insured mail ? C.O.D. <br />4. Restricted Delivery? (Extra Fee) O Yes <br />2• Article Number 7004 0750 0002 5692 4658 <br />(rrerrsfer honr service labeq <br />Ps Form 3811, February 2004 Donrestlc Retum Receipt t02595-024&1540 ? <br />PC <br />CERTIFIED MAIL. Htc;tir I <br />(Domestic Mail Only; No Insurance Coverage Provided) <br />Postalle <br />C3 Certffl d Fee 2 So <br />C3 C3 Retum C3 Redo Fee <br /> <br /> (Endorssmem Requ{red) <br /> ReWicted <br />c R <br />L11 equired <br />(E <br />t <br />[__ <br />C3 - - - - <br />D^ <br />_.I C)FFICiAL USE <br />3z