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Postal <br /> Er CERTIFIED MAILT. RECEIPT <br /> Provided)— <br /> [17 <br /> Ln <br /> CID <br /> a <br /> m Postage $ <br /> M <br /> O Certified Fee <br /> E3 Postmark <br /> p ReturnRetuReclept Fee Here <br /> (Endorsement Required) <br /> C:3 Restricted Delivery Fee <br /> —0 (Endorsement Required) <br /> FLJ <br /> f1J <br /> Total Postage 8 Fees <br /> M <br /> 0 Sent To <br /> ( *... � fe L�P�: <br /> -------- ------------------ <br /> -------------------------- <br /> Street,Apt No.; <br /> or PO Box No. 3 33 S_ C. � --'---____-- <br /> c <br /> City,S !e:ZIPr4 <br /> :rr rr <br /> SECTION . <br /> THIS SECTION COMPLETE THIS <br /> SENDER: COMPLETE <br /> A. Signature <br /> ■ Complete items 1,2,and 3.Also complete ❑Agent <br /> item 4Are. <br /> iveed• X ( G' ❑Addressee <br /> ■ Print y <br /> Td <br /> ddr s n e reversesothahe ou. B. Received by(Printed Name) =te <br /> ■ Attach this card to the back of the mailpiece, m c'' o <br /> or on the front if space permits. �- S <br /> D. Is delivery a essdlffere4t+ftom item 1? 13 Yes <br /> 1. Article Addressed to: <br /> If YES,enter-eci;v ry adpfts below: ❑ No <br /> C.h>✓�o Kee R >'{ <br /> =ter; -a <br /> C 9 sZ 015 3. Service Tge1 <br /> Xcertifigg QaR- ❑;;press Mail <br /> ❑ Regism*d -. turn Receipt for Merchandise <br /> ❑ Insured Mail O.D. <br /> 4. Restricted Delivery?(Extra Fee) ❑Yes <br /> 2. Article Number 7003 2260 0003 3185 9094 <br /> (1-ransfer from service label) <br /> PS Form 3811, February 2004 <br /> Domestic Return Receipt 102595.02-M-1540 <br />