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d <br /> SENDER: <br /> v •Complete items 1 ardor 2 for additional services. I also wish to receive the <br /> a •complete items 3,4a,and 4b, following services(for an <br /> m •Print your name and address on the reverse of this form so that we can return this extra fee): <br /> card to you. ai <br /> -Attach this form to the front of the mailpiece,or on the back if space does not o <br /> permit. 1. ❑ Addressee's Address <br /> 0 •Write'Aetum Receipt Requested'on the mailpiece below the article number. 2. ❑ Restricted Delivery 0 <br /> •The Return Receipt will show to whom the amid,was delivered and the dateOf <br /> o delivered. Consult postmaster for fee. al <br /> 3.Article Ad ressed to: 4a.A 'cle Number d <br /> /� <br /> ^� UGCI/�L F� ��C # Z Z Z CoU a ro <br /> o u 4b.Service Type .�. <br /> ❑ Re istered \ s' <br /> /' `C /�/ /[� 1/ `/ 9 Certified <br /> (JIIQ6A/ ( (C U( lYl �C `�{{r-{ ❑ Express Mail ❑ Insured 5 <br /> ON <br /> �C('\` Return Receipt for Merchandise ❑ COD <br /> _ 7.Dp of Delivery <br /> z N � wZ _ �, <br /> 0 <br /> Si Received By:(Print Name) 6.Addressee's Addre. (Only it requested <br /> and lee is paid) t <br /> g 6.Signature: (Addressee or Agent) <br /> �l <br /> m . X O>, <br /> I <br /> PS Form 3811, Deeember 1994 Domestic Return Receipt <br />