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G� <br />�I ITS ° 3� <br />■ Comp <br />lete 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 />Ms. Cindy Richardson <br />The Citizens State Bank of Ouray <br />PO Box 160 <br />111 Hwy 97 <br />Naturita, CO 81422 -0160 <br />Signature <br />Agent <br />Print d N e) C. Date of Delivery <br />B. Received by (� K /�,1,0�'A' <br />D. Is delivery address different from item 1? ❑ Yes <br />If YES, enter delivery address below: <br />No <br />3. Service Type <br />RrCei Mail® 0 p <br />1:1 Registered Return Receipt for Merchandise <br />❑ Insured Mail ❑ Collect on Delivery <br />4. Restricted Delivery? (Extra Fee) <br />❑ Yes <br />2. Article Number ?014 0150 0 0 0 0 9138 ??41 <br />, (rMrisfbr from Sbrvice label) Domestic Return Receipt <br />PS Form 3811, July 2013 <br />N <br />r $0.48 <br />cc Postage: $3.30 <br />rn <br />rq Certified Fee: $2.70 <br />Er Return Receipt Fee: <br />o $6.48 <br />E3 <br />(,,Total Postage & Fees: <br />Restnctea uenve u� � <br />C3 (Endorsement RAr <br />r--1 Total Postage & Fees $ <br />ED Richardson <br />- LSentTo Ms. Cindy The Citiz 160State Bank of Ouray O ---- - - - - -- <br />r- P O BoX 111 Hwy 97 <br />Naturita, CO 81422'0160 <br />