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C, ?NDER: <br /> L-.1,�.;omplete items 1 and/or 2 for additional services. ri I also wish to receive the <br /> ■Compler&items 3,4a,and 4b. <br /> ■Print your name and address on the reverse of this form so that we can return this following services(for an <br /> • card to you. extra fee): <br /> > ■Attach this form to the front of the mailpiece,or on the back if space does not ar <br /> pem,it. 1. ❑ Addressee's Address V <br /> m ■Write'Retum Receipt Requested'on the mailpiece below the article number. 4) <br /> ■The Return Receipt will show to whom the article was delivered and the date 2 13 Restricted Delivery in <br /> 0 delivered. <br /> 0 Consult postmaster for fee. o <br /> 3.Article Addressed to: F4b. <br /> rti Number c°'i <br /> X91 <br /> �7 a <br /> a ^ ^ <br /> E /OSG �/f./e MQf r No ervice Type <br /> V tT4JI) Mar = I Q0L%Tjo <br /> rn S egistered Certified <br /> x Express Mail °' <br /> _C) , S v x g'09- p ❑ Insured 6 <br /> fn <br /> o S 1 ❑ Return Receipt for Merchandise ❑ COD <br /> a 't c '�� �--� 9s-a o g 7.Date of Delivery <br /> Z 3-- � <br /> 0 <br /> H 5. Received By:(Print Name) <br /> 9 �^ <br /> .Addressee's Address(On y if requested '� <br /> cc and fee is paid) m <br /> r <br /> c 6.Signature: (Addre see o�Agent) <br /> m v <br /> PS Form 3811, December 1994 Domestic Return Receipt <br /> P 291 488 874 <br /> US Postal Service <br /> Receipt for Certified Mail <br /> No Insurance Coverage Provided. <br /> Do not use for Intemabonal Mail See reverse) <br /> Sent to <br /> 7•s� uc /�Gr; o C <br /> mbe So <br /> P5ost Code Cyfice,S te, Z1P <br /> •��G <br /> Postage $ <br /> Certified Fee <br /> Special Delivery Fee <br /> Restricted Delivery Fee <br /> LO <br /> rn Return Receipt S ` 7 <br /> Whom 3 Date NGS <br /> Q Retum Rec o y <br /> Q Date,d Addrmee' Address <br /> mTOTAL Pdstag`S F s/ $ \ D <br /> Postmark oc Date <br /> LL <br /> U) <br /> CL <br />