Laserfiche WebLink
Postal <br /> CERTIFIED WAIM RECEIPT <br /> o <br /> m <br /> (Domestic Mail only,No insurance Coverage Provided) <br /> CID :rs <br /> cc I A R IF <br /> r <br /> CID Postage $ <br /> m Certified Fee <br /> 1:3 Postmark <br /> 1--3 Return Reciept Fee <br /> O Here <br /> (Endorsement Required) <br /> O Restricted Delivery Fee <br /> Tr1 (Endorsement Required) <br /> O <br /> fU Total Postage&Fees $ <br /> fU <br /> Sent To ,� -- ,_ <br /> T� Street,Apt.No.; <br /> - - - -- tj;- ---/-- <br /> or PO Box No. 47 /Ij <br /> City,State,ZIP+4 <br /> pS Form <br /> :ii June 2002 <br /> COMPLETETHIS SECTIONON <br /> COMPLETESECTION <br /> ■ Complete items 1,2,and 3.Also complete <br /> A. Signature ❑Agent <br /> item 4 if Restricted Delivery is desired. X ❑Addressee <br /> ■ Print your name and address on the reverse Received by(Priinte Name) C. Date of Delivery <br /> so that we can return the card to you. B <br /> ■ Attach this card to the back of the mailpiece, <br /> or on the front if space permits. del a -different from item 1? ❑Yes <br /> ❑ No <br /> 1. Article Addressed to: If YES,enter delivery address below: <br /> v;R��VMt�N S <br /> ice Type <br /> " ertified Mail ❑ Express Mail <br /> [3 Registered El Return Receipt for Merchandise <br /> ❑ Insured Mail ❑C.O.D. <br /> 4. Restricted Delivery?(Extra Fee) ❑Yes <br /> 2. Article Number 7002 2030 0003 8788 6305 <br /> (Transfer from service label) Domestic Return Receipt 102595-02-M-1540 <br /> PS Form 3811,August 2001 <br />