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Postal <br /> C3 - ECEIPT <br /> Ln (Domestic Mail oniw Noligurance <br /> co <br /> CO <br /> G n <br /> Postage $ <br /> M <br /> O Certified Fee <br /> O <br /> C3 Return Reciept Fee Postmark <br /> (Endorsement Required) Here <br /> O Restricted Delivery Fee <br /> M (Endorsement Required) <br /> O <br /> ru <br /> Total Postage&Fees <br /> f1J <br /> M <br /> Sent To <br /> Street,Apt.No.; <br /> or PO Box No. <br /> �Q L <br /> City,State,ZIP+4 -- --L�------!/��C ----- _+_'_----- <br /> SECTIONDELIVERY <br /> SENDER: COMPLETE THIS SECTION COMPLETE THIS <br /> ■ Complete items 1,2,and 3.Also complete t�lgnature <br /> ❑Agentitem 4 if Restricted Delivery is desired. ❑Addressee <br /> ■ Print yo*r name and address on the reverse <br /> so that t�acgn return the card to you. g, eceived by(Printed Name) C� ate o DEtivery <br /> ■ Attach this card to the back of the mailpiece, / l <br /> or on the front if space permits. <br /> D. Is delivery address different from item 1? ❑Yes <br /> 1. Artide Addressed to: If YES,enter delivery address below: ❑ No <br /> Jc-�C /� —\ 2 Z 73. Service Type <br /> l., rtified Mail ❑ Express Mail <br /> gistered ❑ Return Receipt for Merchandise <br /> ured Mail ❑ C.O.D. <br /> 4. Restricted Delivery?(Extra Fee) ❑Yes <br /> 2. Article Number 7002 2030 0003 8788 7500 <br /> (Transfer from service label) <br /> PS Form 3811,August 2001 <br /> Domestic Return Receipt 102595-02-M-1540 <br />