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ti <br /> m SEND <br /> ■CompF1611-11OLM0 <br /> s�aando <br /> drtional services. I also wish to receive the <br /> wto qC� ry , followingservices(for an <br /> tlr:. r print your name and address on the reverse of this rt at we can um this e � Q ���� <br /> • a'card to you. i7 m <br /> �'0 m ttach this form to the front of the mail e f 1. Addressee's Address <br /> 2�e permit. <br /> y`"0 Write Receipt Aeque"sred`on the m ' 10 artic nu er. 2. ❑ Restricted Delivery N <br /> z ■The Return Receipt will show to who the article w delivered and the date Consult postmaster for fee. <br /> rU c delivered. <br /> u 4a.Articl mbar E <br /> Qy jr ..ArticleAddrassed_t4: � l/ �Gf! ¢ <br /> cr) a ANTHONY RIVERA <br /> 4b.Service Type 3 <br /> � �, a m <br /> m. E { 13140 MADRONE FOREST RD ❑ Registered Certified fx <br /> ® Er a a NEVADA CITY CA 95959 ❑ Express Mail [3 Insured <br /> cc, <br /> W <br /> ❑ Return Receipt for Merchandise ❑ COD 0 <br /> 0 _ 7• a ot��E7e1 0 ry 3 <br /> N z� <br /> .Received By: (Print Name} $:A ee's d¢r ss( n if requested e <br /> ,� and fes pai F <br /> 5 , <br /> r 7 �9go, <br /> 6.Signatu : (Addressee or Agent yy 1 <br /> rn Receipt <br /> PS Form 3811, December 1994 'M—W--Domes is Retu <br /> s <br />