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y • Complete items 1 endlor 2 r additional services. r / <br /> I also wisu� ieive the <br /> m Come' "��,and 4a&b. ll� following services (for an extra <br /> � • Print your name and address on the reverse of this form sot at we can fee): } <br /> CD return this card to you. m <br /> Attach this form to the front of the mailpiece,of on the back if space 1. Addressee's Address N <br /> ;.as not permit. <br /> d • Write"Return Receipt Requested"on the mailpiece below the article number. S. l " <br /> s 2. El Delivery <br /> • The Return Receipt will show to whom the article was delivered and the date m <br /> o delivered. Consult postmaster for fee. m fu1 <br /> 3. Article Addressed to: 4a. Article Number <br /> m BERNARD G PALKA P 298 999 848 U <br /> fl. 4b Service Type C `� <br /> i E SEARS ROEBUCK CO STORE#128 ❑ Registered ❑ Insured _a <br /> voUi DEPT 824C;AZ-281A CKW6nified ❑ COD 5 _ <br /> y3333 BEVERLY RD ❑ Express Mail ❑ Return Receipt for a' <br /> o O HOFFMAN ESTATE IL 60.179 y- Dat iv¢P Merchandise �„jy'r CID <br /> 3 <br /> Q o <br /> a. <br /> 5. Signature (Addressee) 8. Addressee' dress(Only if requested� <br /> and fee is pa' ! <br /> 10 � <br /> 16. Sig [ H <br /> CO <br /> y PS Form 3811 ecember 1991 *U.S.GPO:1eea--n2-714 ESTIC RETURN RECEIPT <br /> c <br />