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I also wish to receive the <br /> $� " following services(for an <br /> y rC let items_ or 2 for additional seen extra fed <br /> ■� pieta items 3,4a,.and 4b. can return this <br /> rn A <br /> P <br /> d ■prim your name ah address on the reverse of this fo s s not 1. 13 d <br /> 3 M card to you. or e <br /> to <br /> ■Attach this form to the front of the mailpi <br /> permit. Re uastsd'on the m pece b <br /> he a e num er. 2. ❑ Restrlt:ted De Ivory <br /> ■write'Ratum Receipt 4 Consult postmaster for fee. <br /> 0 <br /> The Retum Receipt W 11 shoal to whom the article was d 'lvered and the date 0 <br /> delivered. 4a. cle Nurrtber �. <br /> tY <br /> o,..� d0` <br /> ` ) 'GEORGE GEMELLOS <br /> I N 16 SLEEPY HOLLOW 4b.Service Type AL Certified <br /> } 3 E CA 952.42 p Registered p insured H <br /> } res N o LODT ❑ Express Mail a <br /> ti1-4 4 i Q Return Receipt for Merchandise [3 COD <br /> i t7 t 1 7.Date of Delivery <br /> Ir <br /> d ' <br /> Ln <br /> p., C /� _ _ ON �tf rdptiesfed c <br /> Addressee'._s'Addr`ess?{ 'l%OU4 <br /> a- r; ` Print IN and fee is pal F- <br /> V, F' 5.RecLU <br /> a 13 <br /> Addr see or Agent) <br /> {gnature: ( p rn tic Return Receipt <br /> PS Form 3811, <br /> December 1994 <br />