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i <br /> SENDER: <br /> � ■Complete items 1 and/or 2 for additional services. I also wish to receive the <br /> v+ •Complete items 3,4a, and 4b following services (for an <br /> $ ■Print your naive and address on the reverse of this form so that we can return this extra fee): <br /> card to you $ <br /> ■Attach this form to the front of the maflplece, or on the back If space does not 1. ❑ Addressee's Address <br /> permit. <br /> ■Wnte'Retum Receipt Requested"on the mailpiece below the article number 2. ❑ Restricted Delivery <br /> ■The Retum Receipt will show to whom the article was delivered and the date <br /> C delivered Consult postmaster for fee. . <br /> o <br /> 3 Article Addressed to. 4a Article Number <br /> T.. � )l pip, <br /> '�`. `.j r1"19, i N,f ` <br /> 0-1- <br /> 4b. Service Type 4 <br /> ❑ Registered "eCertiffed °C <br /> m <br /> �3(1x, ��1i I [IExpress Mail Elinsured <br /> ZRatum Receipt for Merchandise ❑ COD <br /> 7 Date of Del very <br /> �' <br /> // / :11% <br /> 5. Receld By- (Print Name) 8. Ad ssee's Address (Only N requested <br /> C! P /�,� c a lee is Old) <br /> t4 11� a, Xi` <br /> ag 6 Sig at ( r �s�►e or Agent) <br /> X <br /> PS Form 3811, December 1994 Domestic Return Receipt <br />