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U.S. Postal ServiceTM <br />CERTIFIED MAILTM RECEIPT <br />(Domestic Mail Only; No Insurance Coverage Provided) <br />For delivery information visit our website at www.usps.com® <br />81001 <br />$5.59 <br />Postage <br />Certified Fee <br />Retum Receipt Fee <br />(Endorsement Required) <br />Restricted Delivery Fee <br />(Endorsement Required) <br />Total Postage & Fees <br />SENDER: COMPLETE THIS SECTION <br />' • 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 />2. Article Number <br />(Transfer from service label) <br />PS Form 3811., February, 094 <br />A. Signature <br />09Yt8/2011 <br />Sent To <br />Street, Ap <br />or PO 80) <br />City, State <br />:,I. <br />PS form <br />TERRY GLENN <br />2375 CHANTALA AVE. <br />PUEBLO, COLORADO 81001 <br />See Reverse for Instructions <br />ugust 2006 <br />COMPLETE THIS SECTION ON DELIVERY <br />D. Is delivery address d <br />If YES, enter delivery <br />TERRY GLENN <br />2375 CHANTALA AVE. <br />PUEBLO, COLORADO 81001 <br />Service type <br />❑ Certified Mall ❑ Express Mail <br />❑ Registered ❑ Retum Receipt for Merchandise <br />❑ Insured Mall ❑ C.O.D. <br />4. Restricted Delivery? (Extra Fee) <br />7011 0470 0000 6879 <br />Domestic Return Receipt <br />❑ Yes <br />nt <br />ssee <br />ery ' <br />102595-02 -M -1540 <br />