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• 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 maiipiece, <br />or on the front if space permits. <br />1. Article Addressed to <br />WILLIAM E. & JACKEY UGOLINI <br />46 U S State Highway 10 <br />WALSENBURG, CO 81089 <br />2. Article Number <br />(Transfer from service label) <br />PS Form 3811, February 2004 <br />D <br />C r- <br />m �'D <br />Z ( 4) 3 <br />CO IV m <br />C•* • <br />7J r1 n. <br />P <br />0 S n <br />co PI m <br />CO O c <br />(D 0 <br />r <br />z <br />COMPLETE THIS SECTION ON DEL /VERY <br />B. Received by (Printed Name) <br />A. Signature <br />X <br />3. Service Type <br />❑ Certified Mail <br />0 Registered <br />0 Insured Mail <br />4. Restricted Delivery? (Extra Fee) <br />7011 2970 0002 7119 9808 <br />0 Agent <br />0 Addressee <br />C. Date of Delivery <br />D. is delivery address different from item 1? 0 Yes <br />If YES, enter delivery address below: 0 No <br />0 Express Mail <br />0 Return Receipt for Merchandise <br />0 C.O.D. <br />0 Yes <br />Domestic Return Receipt <br />1 02595 -02 -M -1540 <br />6801,8 (X) . )Z EI N T i V fv, .,.. >.. ._ _ . .. <br />01 AeML16!H a3e1S S fl 9i 7 "diZ 9 417s s+'i *o I -, j <br />)!JEwySO <br />ead Pa!i!uGD <br />eCaisod <br />of teas <br />ru <br />$ Seed g O6a ;sod leiol ...0 <br />0 <br />awoasdsn•NUnm 3e aRsgaM mo ilsln uol ;euuo;ur Ala/4pp Joj <br />(paprnojd aferanoa eaueensuf oiy !,fiup flew agsatuoO) <br />141303E1 " 111 /IN 1331d111333 <br />''aa!AieS Ielsod es - n <br />(peJlnbaa luewesropua) <br />ea3 NeAiled pe1o14sa8 <br />eJOH (pw!nbaa yuawesiopu3) <br />sod yd!eoaa =yea <br />