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� SENDER: <br /> ■Complete items t and/or 2 for addiflonal services. I also wish to receive the <br /> 'H ■Complete Items 3, 4a, and 4b following services (for an <br /> a Print your name and address on the reverse of this form so that we can return thle extra fee): <br /> card to you <br /> ■Attach this form to the front of the mallpiace, or on the back If space does not 1, ❑ Addressee's Address <br /> permit <br /> ■Wnte'Return Receipt Requested'on the mailpiece below the article number 2. ❑ Restricted Delivery <br /> ■the Return Receipt►Holl show to whom the article was delivered and the date <br /> o delivered. Consult postmaster for fee. <br /> 3 Article Addressed to: 4a Article Number <br /> CL <br /> 1 �lI, '� t"�rt.r•` �,; � '•r,, jy�r' � ('. �' i .1 <br /> E <br /> E '} '; f, �l �` '3 �' 4b. Service Type <br /> r :%, A A% I ' , i- 0. {,r.r�� ❑ Registered Certified � <br /> of ; " '• ' .',, ❑ Express Mail ❑ Insured S <br /> PHetum Receipt for Merchandise ❑ COD <br /> 7, Qate of Delivery. // <br /> Z <br /> 5. Rec �ved By: (P int Name) S Addressee's Address (Only if requested <br /> and fee is pard) az <br /> 6 Sig ' tura. eb Agent) <br /> o <br /> X <br /> PS Form 3811, December 19941 Domestic Return Receipt <br />