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iii iiiiiiiiuiiiiii <br />999 <br />~_ <br />" SEN ER: <br />'Q <br />I aie0 wish t0 r¢c¢iv¢ [he <br />Complete items 1 and/or 2 for adtlitionel services. <br />N <br />y compiere gems 3. and as a u. following services Itor an extra m <br />U <br />~ • Print your name and atldress on the reverse of this form so [hat we <an feel ~` <br />m rtturn this card to vou. <br />• Attach this loan [o the Iron( of the mailpiece, or on the hack i t space 1. ^ Addressee's Add/ea5 y <br />does not permit. <br />m <br />« • Write"Relum Receipt Requested'"on the mailpiece below the article number. 2 ~ Re5[rlCt¢d D¢lVery tl <br />• The Re[urn Receipt will show to whom the artmle was delivered a nd the date Y <br />c delivered. Consult ostmas[er (or fee. m <br />v 3. Article Address@d to: 4a. Article Number ~ <br />m P 296 603 187 9 <br />a BASIN RESOURCES INC 4b. Service Type <br />° 14300 HIGHWAY 12 ^ Registered ^ Insured <br />a <br />° <br />WESTON CO 81091 C ~ <br />~ Certitied ^ COD <br />.y <br />W `t n Express Mail ^ Return Receipt for <br />~ 7 <br />G Merchandise <br />~ ~ _ <br />7. Date I Delivery w <br /> ~ <br /> T <br />~ 5. Sig atur Addres eel 8. Addressee's Address (Only if requested Y <br />~ ~ and tee is paid) ~ <br />r t <br />_ <br />~ 6. Signature IAgentl 1' <br />7 <br />> PS Form 17, December 19gt ,:u.s.cRO:teaz~za..tn DOMESTIC RETURN RECEIPT <br />N <br />