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h <br /> SENDER:U1 VU! <br /> v ■Complete iterr id/or 2 for a itiona sennces. Iso wish to receive the <br /> H ■Complete item. 'a,and 4b. .,owing services(for an <br /> v ■Print your name and address on the reverse of this form so that we can return this extra fee): <br /> card to you. <br /> j ■Attach this form to the front of the mailpiece,or on the back if space does not 1. El Addressee's Address •5 <br /> P permit. y <br /> y ■Write'Retum Receipt Requested'on the mailp1:1iece below the article number. 2. Restricted Delivery in <br /> .t. ■The Return Receipt will show to whom the article was delivered and the date <br /> delivered. Consult postmaster for fee. ° <br /> o <br /> 3.Article Addressed to: 4a,Article Number m <br /> 4-111 1 tc:3 042, <br /> E BROAD BASE INC 4b.Service Type <br /> °0 4000 YOSEMITE TOAD STE 7 ❑ Registered CYCertified ¢ <br /> rn <br /> w LATH OP CA 95330 ❑ Express Mail ❑ Insured <br /> N <br /> ¢ ❑ Retum Receipt for Merchandise ❑ COD <br /> o ` 7.Date of Delivery,IWL <br /> 1 li/ a <br /> 5. ed By:(Priv Name) 8.Addressee's dress(Ont if requested <br /> LU and fee is paid) i t <br /> Signature: (Addressee or Agent) <br /> o X <br /> T <br /> N PS Form 3811, December 1994 Domestic Return Receipt <br />