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Certified Mail Receipts V�t'1 too <br /> COMPLETEi SENDER: <br /> •N COMPLETE THIS SECTIONON DELIVERY <br /> ■ Complete items 1,2,and 3.Also complete A. Signature <br /> item 4 if Restricted Delivery is desired. r gent <br /> ■ Print your name and address on the reverse X In Addressee <br /> so that we can return the card to you. B. eceived (Lr��IN e) C. ate of Delivery <br /> ■ Attach this card to the back of the mailpiece, ��� y a 7 /1/A <br /> or on the front if space permits. 1 / T` <br /> D. Is delivery address different from item 1? ❑Yes <br /> 1. Article Addressed to: If YES,enter delivery address below: l No <br /> John R. Kur zer <br /> 24463 CR 11 <br /> Haxtun, CO 80731 <br /> 3. Service Type <br /> ❑Certified Mail ❑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 7011 3500 0002 9605 7642 <br /> (Transfer from service label) <br /> s <br /> PS Form 3811, February 2004 Domestic Return Receipt 102595-02-M-1540 <br /> Postal <br /> CERTIFIED AAAIL,,, RECEIPT <br /> ru (Domestic Mail Only; <br /> �! * - <br /> G7 <br /> °^ Postage: <br /> ru $0.485 <br /> p Retur Certified Fee: <br /> 0 (Endorsem $3.45.` <br /> o Return Receipt Fee: � <br /> Restdcte( $2.80, ; <br /> (Endorsers n <br /> O f; <br /> Ln Total Postage°tal&Fees ale & Fees:., $� 35 <br /> m <br /> Sent To _ <br /> `�J}USF s <br /> ---------------- ---- <br /> Street,Apt No.;- John R. Kurtzer ------------- <br /> O or PO Box No. 24463 CR 11 w <br /> City,State,ZlP+4 -------------- <br /> Haxtun, CO 80731 <br /> :rr rr. <br />