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BOX 1628 <br />P O.. State and ZIP Cotle <br />COLORADO SPRINGS CO 80 0 <br />Postage S- - <br /> pLOn <br /> <br />Cerldietl Fee s~ <br />~~' <br /> ~ .~ <br />Special Delivery Fee ` (7 <br /> <br />Reslnded Delivery Fee I `~ <br /> .~ .,i~ <br />Return Receipt showing <br />l <br />h <br />D <br />D <br />d ~'~Dr <br />' <br />~~ <br />ivere <br />to w <br />om and <br />ate <br />e ~ ; <br />. <br />. ~, <br />Relurn Receipt showing to whom.. I + <br />Dale, and Adtlres5 0l Delivery <br />TOTAL Postage and Fees _S <br />Poslmaik Or Dale 1 <br />SLOW <br />Q <br />O <br />0 <br />0 <br />I <br /> <br />r , _ <br />xi P x672 1556 34,5 <br />:j " ~ RfiCEIPT FOR CERTIFIED~A~IAi4~ <br />ND INSURANCE COVERAGE PROVIDEp-~ <br />NOi FOP INTERNATIONAL MAIL ' <br />lSee Reverse) <br /> <br />t~ <br />~~a <br />Se t to <br />*tARK A. HEIFNER~ <br />Street and No <br />. 0~ E <br />P O.. State and ZIP Code <br />GO 80210 <br />Postage S <br />Cendied Fee ~ G ~~,.,_, <br />i Fall <br /> jr <br />Special Delivery Fee 1 q <br />G <br />IJ <br />Resinned Delivery Fee ~\, i w t ~~ <br />` <br /> , <br />JPrIL,- <br />Relurn Rec w <br />h <br />ntl re <br />t p <br />~ <br />o w <br />om a V <br />Return Receipt showing to whom. - <br />Dale. and Adtlress of Delivery '' - - <br />TOTAL Postage antl Fees 5 r ~ i <br />1 <br /> <br />Postmark or Dale <br />: <br />J ... r <br />. <br />J <br />O <br />C <br />0 <br /> <br />