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m SENI also wish o receive the F <br /> V ■corn to i 2 for additional services following services(for an <br /> w ■Com lets items 3.4a,and 4b. t can return this extra fee): ai + <br /> m:. ■Print your name and address on the revs e s . <br /> CO card to you. t ba ce $not i. ® dr�sSpe cess e <br /> d:' ■Attach this form to the front E!1 t��� <br /> >,. <br /> permit. th c number. 2. Restricted Delivery u) ' <br /> ■Wnte'Retum Receipt Requ Wothe a Q <br /> ■The Retum Receipt will show to ho m t e article was delivered and the data Consult postmaster for fee. <br /> C delivered. N <br /> G4a.Article Number W s, <br /> 3.Article Addressed to: �• i <br /> o � <br /> 4b.Service ype d <br /> CL Certified °C <br /> E [2 Registered <br /> as <br /> insured <br /> Express❑ Express Mail an <br /> V) C] Return Receipt for Merchandise ❑ CODLU <br /> i <br /> C 7.It liver}r/ T <br /> Y <br /> � S.Addressee's Address(Only if requested � <br /> cc 5.Received 8y: (Print Name} and fee is paid) r <br /> t— <br /> W <br /> g �6.Signature: <br /> ee or A nt) <br /> T X Don te is Return Receipt <br /> PS Form 3811, December 1994 <br />