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III Illlllllllllllll <br />999 <br />" SENDER: <br />y •C«npl•t• items t rvtd'« 2 for •dd6onr rrrNC•e. I also wish to receive the <br />• .Complete ilem• 3, Is, •rM fib. fdlowing services (}br Bn <br /> • Pdre your name and etltlrese on the revaee d IhN fonrt w that ws can Mum lMS eMr0lee): <br /> rartl la you. <br />•Merh this arm to the hord d the mailpiece, « on the wrk if specs doe. nd <br />1. ^ Addressee's Address 8 <br />Z <br />~ • W~ri a Wetum Heroi R waled' on it~e mNgece below pte erlide number. <br />~ <br />M <br />2. ^ RBStdded DBIIVBry Y <br />rR <br /> ow to whom aw Mida was tlelivend end the date <br />•7he Ralum Racelp <br />wA ~ <br />C tleliverotl. Consult pOSVltestef tOr f6e. <br /> g <br />g <br />v 3. Artlcle Addressed to: 4a. ArCCIe Number b <br />e Ms Mary Seifert Z 434 941 575 <br />E <br />n Mike L'oleman and Jerry Seif ervice7ype <br /> 60160 Hwy 69 N C ~ tend xltj Certified <br /> Westcliffe CO 81252 ~~ ^ Mell~~ ^ Insured a <br /> y ~ Rem eceiptforMercharldse ^ COD ° <br /> d ~ Delivery <br /> ~ 0 <br /> r <br /> 5. Received By: (Print Neme) Zf, ressee's Address (Onlyil requested ~ <br /> end lee is paid) 9 <br />F <br /> 6. Signatu ddressee arAg nQ <br />r X <br />• PS Form 3811 Oscember 994 ~ t02595~97-8-0179 Domestic Retum Receipt <br />Z M3 4 9 4 sp.~~13 <br />US Postal Service ~)/Q ~` mQ,~ a <br />lieceipt for Certified~ilAatl_ <br />No Insurance Coverage Provided <br />Do not use for International Mail See reverse ', <br />~loMary Seifert <br />69 N <br />81252 rn <br />$ -~ -~ V <br />Fee <br />Spedal Delivery Fee <br />Restdded Deevery Fee ~ <br />C <br />ietum Receipt Showing to <br />Nhom d DatyUp,Tverep,. ~ (r ~ ~~~ ~ <br />(n <br />a <br /> <br />tyl \ /.-/ <br />rn <br />a <br />