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I a' wish to receive the <br /> d SENDER: follo`irvices (for an extra u <br /> 9 . Cmnplete items t 21or additional services. .` <br /> 'N &b. feel: d <br /> N . Complete items W <br /> w . Print Your name a a cess on the reverse of this form so that pa ca i El <br /> Addressee's Address <br /> m return this card to You. <br /> or on the back it space <br /> n <br /> > . Attach this form to the front of the mailpiece, 2 � Restricted Delivery '� <br /> m N <br /> does not permit. cc <br /> m Write""Return fleceiptRequested"onihe mailpiece below the article num Consult postmaster for fee. <br /> .t+ . The Return Receipt will show to whom the article was delivered and the date ` <br /> C call ered. 4a. Article Number �q� <br /> 3 <br /> y 3. Article Addressed to: 2 <br /> m -- _— --- "— ' _ \ 4b. Service Type a <br /> [3 Insured <br /> CHL' iI ' [.ilw: 'i` Registered <br /> E ATTN:J RUSSELL JACKSdN p,6ertified [3 COD y <br /> U PO <br /> 'OX <br /> 2048 ❑ Express Mail ❑ Return Receipt for <br /> r \• Merchandise p <br /> STJCYT0N,CA 95231 - - `J 3 <br /> -W 7, Date of Dell!ve Er ? j •' °° <br /> 2 > <br /> Q 8. Addressee's Address (Only <br /> if requested G <br /> va <br /> eel <br /> dressand fee is paidl L <br /> 5. Sign l•' <br /> f <br /> S R. ignature (Agent) , <br /> STIC RETURN RECEIPT <br /> > PS Form 3811, December 1991 AU.S.GPO:L9B2—a2360P DOME <br />