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�L5 � t'L a- pr3 -0'q <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 />I. Article Addressed to: <br />Ms. Paula Weeks <br />Kit Carson County <br />251 62b._Street <br />--r'O. Box 160 <br />Burlington, CO 80807 <br />A. Signature <br />�( P1,Agent <br />N. 0 Addressee <br />B, Received by (Printed Name) 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 />3. Service Type <br />CWCertified Mail 0 Express Mail <br />0 Registered 0 Return Receipt for Merchandise <br />0 Insured Mail 0 C.O.D. <br />4. Restricted Delivery? (Extra Fee) 0 Yes <br />2. Article Number <br />(Transfer from service !abet) 7 011 3500 0 0 0 2 9605 5 6 5 5 <br />PS Form 3811, February 2004 Domestic Return Receipt 102595 -W-IM -1540 <br />Postal Servicem., <br />QTIFIFD MAIL,., RECEIF <br />4 (Famestic Mail Only; No Insurance Coverage Provided) <br />For delivery information visit our website at www.usps.carrt� <br />Total Postage & Fees <br />U <br />r" Ms. Pula Weeks - �' 17' <br />Kit Carson County <br />Q sire4ti pr: ; 251 16th Street <br />(� or PO Box No.,.- »_.,.."' .,.. <br />Gity, Slate, Z1Pr <br />P.O. Box 160 <br />Burlington, CO 80807 <br />Certitod Fee <br />ru <br />Postmark <br />C3 <br />0 <br />Return Receipt Fee <br />( Endo(sement Ra%iired) <br />HOW <br />3 <br />Restricted Delivery Fee <br />(Endorsement Required? <br />Total Postage & Fees <br />U <br />r" Ms. Pula Weeks - �' 17' <br />Kit Carson County <br />Q sire4ti pr: ; 251 16th Street <br />(� or PO Box No.,.- »_.,.."' .,.. <br />Gity, Slate, Z1Pr <br />P.O. Box 160 <br />Burlington, CO 80807 <br />