WQCS00143_DV-2021-0163 GC_20211123

U.S. Postal Service -
CERTIFIED MAIL° RECEIPT
r-
._0
P-
m
ra
O
O
u'I
m To'
O
r-R S
ru
Domestic Mail Only
For delivery information, visit our website at www.usps.conr".
Certified Mail Fee
$
Extra Services & Fees (check box, add fee as appropriate)
❑ Return Receipt (hardcopy) $
❑ Return Receipt (electronic) $
❑ Certified Mall Restricted Delivery $
❑ Adult Signature Required $
❑ Adult Signature Restricted Delivery $
Postage
Theresa Coletta, Mayor
s Town of Burnsville
t PO Box 97
C __ Burnsville, NC 28714-0097
Postmark
Here
e Reverse for Instructions
SENDER: COMPLETE THIS SECTION`
• Complete items 1, 2, and 3.
■ Print your name and address on the reverse
so that we can return the card to you.
• Attach this card to the back of the mailpiece,
or on the front if space permits.
COMPLETE THIS SECTION ON DELIVERY
EMOval",
B. Received by (Printed Name)
0 Agent
❑ Addresser
C. Date of Delivery
/-
1. Article Addressed to: D. Is delivery address different from item 1? 0 Ye
If YES, enter delivery address below: 0 No
Theresa Col yor
o ern§v"�i1ie
PO Box 97
Burnsville, NC 28714-0097
1111
111111111111111
11
11111111111111111111
9590 9402 5272 9154 5865 50
2. Article Number (Transfer from service label)
7021 0350 0000 1637 6667
PS Form 3811, July 2015 PSN 7530-02-000-9053
3. Se ice Type
t Signature
ult Signature Restricted Delivery
ertified Mail®
Certified Mail Restricted Delivery
❑ Collect on Delivery
❑ Collect on Delivery Restricted Delivery
❑ Insured Mail
•
■
r
A
❑ Priority Mail Express®
❑ Registered MaliTM
❑ Registered Mail Restricts
Delivery
❑ Return Receipt for
Merchandise
❑ Signature ConfirmationT^
❑ Signature Confirmation
Restricted Delivery
DV-2021-0163 (TH)
WQCS00143 YANCE Domestic Return Receipt