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G <br /> I also wish to receive the <br /> BENDER' ,` following services(for an <br /> 0 Complete items 1 ardor 2 for additloml services. YN9 IV return this extra tee). 4 <br /> m ■Complete items 3.4a,and 4b. of this form so that we can 1 <br /> the reverse �.❑ Addressee's <br /> cess <br /> • Pnm your name and address on back it space does not <br /> card to you. mail lace,yr an the 2.13 <br /> Restricted Delivery 4 <br /> ■Attach this form to the front of the p ece below article numbOr. Consult postmaster for fee. <br /> rrn4: t Re uested'an the mailp' a date m . <br /> a�ri{te Aaturn AeceiA. R article was.— <br /> and th <br /> The Return Receip`*11 show to whom the f 4a Article Numberit 4 <br /> delivered. "' , /x�,' 78 70-5— <br /> �i 3 ' <br /> ,&TTN PA's MEEKS 4b.Service Type �Certified <br /> PACIFIC AUTO CENTER ❑ Registered [} insured r- <br /> CL <br /> (3 Express Mail t <br /> =AC3AMp�A 9 95220 ❑ Retum Receipt for Merchandise ❑ COD <br /> 7.Date of Delive <br /> ted x <br /> - S.Addressee's Address( ry if reques c <br /> Print Name) and fee is paid) s <br /> ` e ei - <br /> K <br /> Rg.Signature:(Add see or Agent) --� Domestic Retui- Receipt <br /> �( t ozsss sa a o2ae <br /> n pS Form 3811,De mbar 1994 <br />