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VSENDER <br />a. Complete items 1 and/or2.for additional services.• <br />i a7 Complete items 3, 4a, and 4b. •'. , <br />N " your name and address on the reverseof this form so that we can retum this <br />C ''Card to you. <br />>Attach this form to the•front of the mailpiece, or on the back if space does not <br />i ... .permit: <br />d ■ Write'Retum Receipt Requested' on the mailpiece below the article number. <br />■The Return Receipt will show to whom the article was delivered and the date <br />c delivered. <br />• °' Lance Wade X7008 <br />• d <br />• Western Fuels - Colorado, LLC> <br />g P.O. Box 628 <br />• Q Nucla, CO 81424 <br />G <br />a <br />Q <br />•Z <br />Q <br />, W <br />2 <br />- O <br />5. Received By: (Print Name) <br />_ ... k i7) <br />6. Signature: (A essee or lent <br />PS Form 3811, Dece ber 1994 <br />1140 <br />uNait_z_ Leipattrz. <br />✓ l l 2n 11 0.sti r� <br />GAc.bi- 0 of <br />I also wish to receive the <br />following services (for an <br />extra fee): ai <br />1. ❑ Addressee's Address <br />2. ❑ Restricted Delivery i» <br />Consult postmaster for fee. <br />0004 5015 3191 <br />4b. Service Type <br />❑ Registered Certified <br />❑ Express Mail ❑ Insured <br />❑ Return Receipt for Merchandise ❑ COD <br />7. Date of Delivery <br />8. Addressee's Address (Only if requested <br />and fee is paid) <br />Domestic Return Receipt <br />