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0 <br />m <br />0 <br />a> <br />d <br />• <br />c <br />0 <br />0) <br />d <br />a <br />E <br />0 <br />SENDER: = <br />• Complete items 1 and/or 2 for additional services. <br />• Complete items 3, 4a, and 4b. <br />• Print your name and address on the reverse of this form so that we can retum this <br />card to you. <br />• Attach this form to the front of the mailpiece, or on the back if space does not <br />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 <br />delivered. <br />3. Article Addressed to: <br />Roatcap Owners Access Road Maintenance, John <br />1552 4005 Drive <br />- - ( o <br />/7/4 y f<34C k rck <br />5 i I 13 X 4= / ( 1 / fr 2 <br />5. Received B : (Pri Name) <br />6. Sign <br />X <br />PS Form 3811, <br />e: (Add <br />or Ager____ <br />ember 1994 <br />I also wish to receive the <br />following services (for an <br />extra fee): <br />1. ❑ Addressee's Address <br />2. ❑ Restricted Delivery <br />Consult postmaster for fee. <br />7008 3230 0002 7252 9392 <br />Ak Type <br />Egger :ered <br />❑ Express Mail <br />❑ Retum Receipt for Merchandise <br />RECEIVED <br />MAY 1 1 2012 <br />Certified <br />Insured <br />COD <br />7. Date of Delivery <br />8. A'ddre sea's Address (Only if requested <br />and fee is paid) <br />C nfq 1-03 bc-431 A144 <br />l 5`0:en 'k,a.On <br />i eclamation, <br />Mining and Safety <br />Domestic Return Receipt <br />