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v SENDER, r I aisr wish to receive the <br /> • Complete items 1 an" ' for additional services. al <br /> � • Complete items 3 b. followices (for an extra o <br /> N • Print your name anA#�e�rs on the reverse of this form so that we can fee): ,m <br /> b return this card to you. <br /> 1. ❑ Addressee's Address y <br /> • Attach this form to the front of the mailpiece,or on the back if space 6 <br /> does not permit. 2. ❑ Restricted Delivery 1 <br /> L . Write"Return Receipt Requested"on the mailpiece below the article number Consult ostmaster for fee. <br /> •' • The Return Receipt will show to whom the article was tlelivered and the dalecc <br /> 0 tlelivered. 4a. Article� Q^ber ^ U16 B <br /> 3. Article Addressed to: _ 35 •IYv I(�(/ l <br /> r• - ,I 4b. Service Type <br /> NORTHERN UALlFOR!!A fR"-1T `' ❑ Istered ❑ Insured <br /> ATTN: BRUCE SUTHERLAND [I COD <br /> `— <br /> Certified <br /> 0 P.C. BOX D ❑ Express Mail ❑ Return Receipt for <br /> VICTOR,CA <br /> 95253 Merchandise w <br /> � 7. Date of�Deli <br /> •�y o <br /> O > <br /> Q8. Addressee's Address(Only n requested a <br /> 5. S' ature (Address and fee is paid) L <br /> _ r <br /> r <br /> 5, ignature (Agencc <br /> ) <br /> > PS Form 11, December 1991 *U.S.GPO:leB2-323402 DOMESTIC RETURN RECEIPT <br /> w <br />