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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 />JAMES & RHONDA HRIBAR <br />1187 CR 640 <br />WALSENBURG, CO 81089 <br />2. Article Number <br />7011 2970 0002 7119 9792 <br />(Transfer from service labeO <br />PS Form 3811, February 2004 <br />COMPLETE THIS SECTION ON DELIVERY <br />B. Received by ( Printed Name) <br />A. Signature <br />X <br />Domestic Return Receipt <br />D. Is delivery address different from item 1? 0 Yes <br />If YES, enter delivery address below: 0 No <br />3. Service Type <br />o Certified Mail <br />o Registered <br />o Insured Mail <br />4. Restricted Delivery? (Extra Fee) <br />< —a <br />r < 03 <br />; • '"Nj M <br />rTi <br />Z Qe <br />co <br />c cy) <br />73 4 <br />0 0 <br />C) 0 <br />0 > <br />co <br />o <br />—a 70 <br />C73 <br />CO > <br />I <br />etuoxsdsrrhvinm W amsqam ino ms!A uogeuuolul Liannap ro4 <br />(papptard afieranoa aauernsui ON Auo lien ousatuoa) <br />1d13031:1"11VIA1 031Allti33 <br />onaoyuas lelsod Sfl <br />- - - ,- • -_ • ' <br />- • •: . <br />• " " <br />• • <br />, eieH <br />)pewysod <br />o Express Mali <br />o Return Receipt for Merchandise <br />o C.O.D. <br />6901.9 OD '021119N3S1VM <br />0-fro •‘. o 1 <br />•L (. L. L ' N Od JO <br />1V8I'dH VCINOH21 S31A1VC '''''" <br />o Agent <br />o Addressee <br />C. Date of Delivery <br />Yes <br />102595-02-M-1540 <br />V 0091 Wi Sd <br />7119$ <br />• <br />ru <br />esepod 150.1. –0 <br />(parbou wewesiopua) <br />aaj kanflao papplsau <br />(parbeEi tuetuesiopu3) <br />eej Idisoau Lunie8 <br />ru <br />eleA Pugin <br />arisod <br />- : <br />–0 <br />ru <br />1 <br />' , • <br />