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I ' <br /> rr r <br /> I <br /> Complete items 1.2, and 3-Nso complete A Signature <br /> item4 g lRestdcted Delivery is desired. 0 Agent <br /> I Prinlyour name andaddressonthe reverse x ❑Addressee <br /> so that We can return the Card to you. S.ReceNed by(Printed Name) C.Date of Delivery <br /> ■ Attach this card to the back of the nalipiece, <br /> or on the front if space permits. <br /> I Mich Addressed ro. D.Is delivery address different from Rem 17 0 Yes <br /> If YES,enter delivery address below: I7 No <br /> V-sc . Gco&e 'evdr M8N)%:5y <br /> S�t:c�-o�e�1'so,eW gss�d-o'�oo <br /> 3. Service Type <br /> AfCediaed Mail- 13 Pdodty Mail Express;7 <br /> ❑Registered oeRetum Receipt for Merchandise <br /> ❑Insured Mall ❑Collect on Delivery <br /> 4. Restricted Delivery?(Extra Fee) ❑yes <br /> 2 Mica Numbar 7014 2870 0001 6534 3995 <br /> (lramlerfro servhe labs) <br /> Ps Form 3611,July 2013 Dor be Return Receipt <br /> U.S. Postal Service" <br /> CERTIFIED MAILO RECEIPT <br /> w un Domestic <br /> ® v- o• <br /> rr m <br /> rn rn rJ /y;�� pp pp �� �c pp�� <br /> n rn <br /> e"r � Postage a <br /> .n ..a <br /> � r3 Gedaed Fee <br /> ❑ O Rehmp(Fndorsanert�j0F� Postmark <br /> ❑ O Regdred) <br /> ❑ C3 <br /> ne`lebd aelbery Far <br /> ❑ p IEndarrenart Reg <br /> r- r <br /> eU Trial Posepea Pon <br /> N re <br /> " —msc ri r-9 <br /> 6ire��aloc Snap; <br /> dy.sa:o,aP.r Sacrdcnen'tD.C`A t1581`d�t�4t0 <br />