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Certified Mail Receipts <br /> v <br /> COMPLETE <br /> ■ Complete items 1,2,and 3. 4R ' <br /> 7((Printed <br /> ■ Print your name and address on the reverse ❑Agent <br /> so that we can return the card to you. ❑Addressee <br /> ■ Attach this card to the back of the mailpiece, B. ame) C. Date of Delivery <br /> or on the front if space permits. UN 2 6 2017 <br /> 1 Article Addressed to: D. is delivery address different from item 1? ❑Yes <br /> Carolyn Tice If YES enter delivery address Delow. D No <br /> City of Walsenburg <br /> 525 S.Albert <br /> _,_-WW1enburg,CO 81089 <br /> - - - - - - — Se v!cC:Tv Pe C'Frvrr?b ai Expres; <br /> .,unit biynu[u'o a Rtyis[mea fmdtl'" <br /> Adult Sig,ia[urE Festncted Wiveiy 0-Registered Mail Restricted <br /> Certified Mai115 Delivery <br /> r Certified Mail Restricted Delivery ❑Retum Receipt for <br /> Collect on Delivery Merchandise <br /> 9 Grtirlo Ni imhar?ransfar from sPrvrce lahall---�LJ Collect on Delivery Restricted Delivery El Signature ConfirmationT"' <br /> 7 014 212 0 0001 7885 7467 til ❑Signature Confirmation <br /> jtl Restricted Delivery Restricted Delivery <br /> PS Form 3811, July 2015 PSN 7530-02-000-9053 Domestic Return Receipt <br /> Postal <br /> ■ , m . ■ <br /> [� Domestic Mail Only <br /> CoFor delivery information,visit our website at WWW.USPSX0M�-"- <br /> Co Postage: $Q,460 <br /> r` Certified Fee: <br /> a $3. 50 ark <br /> o Return Receipt Fee: , r 5 i a <br /> C3 c ° <br /> C3 (Total Postage and Fees: $6.56- <br /> ru <br /> r-1 Total Postage&Fees <br /> Rl <br /> Sffd To Carolyn Tice <br /> City of Walsenburg <br /> r 3`beef&iipt.iUo. 525 S_Albert <br /> 171- or PO Box No. Walsenburg,CO 81089 <br /> Ciry;State.Z1P+4 <br /> PS Form <br /> :00 July 2014 <br />