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2013-04-08_REVISION - M2001107
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2013-04-08_REVISION - M2001107
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Entry Properties
Last modified
8/24/2016 5:19:17 PM
Creation date
4/16/2013 4:32:52 PM
Metadata
Fields
Template:
DRMS Permit Index
Permit No
M2001107
IBM Index Class Name
Revision
Doc Date
4/8/2013
Doc Name
CERT. MAIL RECEIPT - SI-01
From
DRMS
To
OPERATOR
Email Name
PSH
Media Type
D
Archive
No
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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 mailpiece, <br />or on the front If space permits. <br />1. Article Addressed to: <br />Mr. Chrie Zadel <br />..-Northern Colorado Constructors. Inc. <br />FR` 9075 WCR 10 <br />Fort Lupton. CO 80621 <br />A. Sign <br />A. WO ❑ Agent <br />sg-�� <br />Addressee <br />B. Received by (Printed Name) C. Dat of ge livery <br />1 WC/3 <br />D. Is delivery address different from item 1? ❑ Yes <br />If YES, tinter delivery address below: ❑ No <br />3. Service Type <br />❑ Certified Mall ❑ Express Mail <br />❑ Registered ❑ Return Receipt for Merchandise <br />❑ Insured Mail ❑ C.O.D. <br />4. Restricted Delivery? (Extra Fee) ❑ Yes <br />2. Article Number 7010 10 6 0 0001 0 9 3 6 8105 <br />(Transfer from service label) <br />PS Form 3811, February 2004 Domestic Return Receipt <br />UNITED STATES POSTAL SERVICE <br />0 <br />102595 -02 -M -1540 <br />First -Class Mail <br />Postage & Fees Paid <br />USPS <br />Permit No. G -10 <br />• Sender: Please print your name, address, and ZIP +4 in this box • <br />l�lil;;ili�;I;Iriililr n �li�lill�rilii3i':rll;rr n Ill�Il�rllrllrl <br />ti1'i -//3 <br />✓ �Z -D/ i�fiG�r/�ST G��� -R ��'vP�,✓ �i;G.i -�Pi <br />
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