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Certified <br />SUBJECT: <br />PROJ ECT: <br />DATE: <br />REMARKS: <br />Mail Receipt <br />E?ud c,c poi ;cam op.,' we w ;7 . r-' z <br />O2 At t) e.v - &t6 Wt - a 0/ 3 o to <br />/4, l y, 2c) 1 3 <br />1/4 � [g `r <br />U.S. Postal Service,. <br />CERTIFIED MAILU RECF!DT <br />(Domestic Mall Only; No insurance, r: l er.:gt Pmo; ±ed) <br />For delivery Information visit our'..,obalte at www.usps.corar <br />1 <br />Postage <br />Certified Fee <br />Retum Receipt Fco <br />(Endorsement Required) <br />Restncted Delivery Fee <br />(Endorsement Required) <br />PS Form 3800, <br />5 <br />uSps <br />Postmark <br />Hero <br />Total Postage 8 Fees S I� <br />nt To <br />Street, Apt No.; WILLIAM E. & JACKEY UGOLINI <br />or PO Box No <br />CV,,State, Z,P +446 U S State Highway 10 <br />WALSENBURG, CO 81089 <br />r <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 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 />COMPLETE THIS SECTION ON DELIVERY <br />A. Signature <br />Domestic Return Receipt <br />B. Rqceived by ( Print / d N <br />to 1Ifit lit Ill <br />1 <br />D. Is delivery ad different <br />If YES. enter delivery addre <br />3. Service Type <br />❑ Certified Mail <br />❑ Registered <br />❑ Insured Mail <br />7011 2970 0002 71]A 9808 <br />1 z< :Agent <br />'y ' ❑ Addressee <br />M C. Date of Delivery <br />PR- 5`n <br />m item 1? ❑ Yes / <br />low: ❑ No <br />4. Restncted Delivery? (Extra Fee) <br />❑ Express Mail <br />❑ Retum Receipt for Merchandise <br />❑ C.O.D. <br />❑ Yes <br />102595 -02- M•1540 <br />