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U.S. Postal ServiceTM <br />CERTIFIED MAILTM RECEIPT <br />(Domestic Mail Only; No Insurance Coverage Provided) <br />Postage: <br />Certified Fee: <br />Return Receipt Fee: <br />Total Postage & Fees: <br />(Endorsement tiegwrww <br />Restricted Delivery Fee <br />(Endorsement Required) <br />Total Postage & Fees <br />0 <br />0 3. Article Addressed to: <br />0. <br />• Theresa M. Berrien <br />• P.O. Box 1614 <br />it Hayden, CO 81639- 1614_ <br />cc <br />o _ <br />z <br />5. Received By: (Print Name) <br />Lk' Signature: (Addressee or Agent) <br />gym <br />PS Form 3811, December 1994 <br />S. T <br />Theresa M. Berrien <br />P.O. Box 1614 <br />Hayden. CO 81639 -1614 <br />d SENDER: <br />o •Complete items 1 and/or 2 for additional services. <br />rn <br />•Complete items 3, 4a, and 4b. <br />H • Print your name and address on the reverse of this form so that we can retum this <br />card to you. <br />d ■Attach this form to the front of the mailpiece, or on the back if space does not <br />El permit. <br />• ■ Write'Retum Receipt Requested' on the mailpiece below the article number. / <br />•The Retum Receipt will show to whom the article was delivered and the date u, <br />• delivered. <br />7008 3230 <br />$0.44 <br />$2.85 <br />$2.30 <br />E <br />I also wish to receive the <br />following services (for an <br />extra fee): <br />l�rddressee? Address <br />2. 0`Restricted livery <br />Consult postmastei'for fee <br />9f� ^- <br />0002 -7.22 3,.06 <br />4b. Service Type <br />❑ Reg ettered Certified <br />❑ Express Mail \ k-, _• O L� In <br />❑ Retum Receipt for Merchandise', D'COD <br />7. Date of Delivery <br />8. Addressee's Address (Only if requested <br />and fee is paid) <br />Domestic Return Receipt <br />