2013-09-11_REVISION - M1999033 (6)

Home Browse Search

• Complete items 1, 2, and 3. Also complete item 4 if Restricted Delivery is desired. • Print your name and address on the reverse so that we can return the card to you. • Attach this card to the back of the mailpiece, or on the front if space permits. 1. Article Addressed to: C.Q AS C6mor) y(ala A. Signature X El Agent i ❑ Addressee B. Recei esi.by (Printed Name) C Date of Delivery �- x-4-13 D. Is delivery address different from Item 1? ❑ Yes If YES, enter delivery address below: ❑ No 3. rice Type Certified Mail ❑ Express Mail ❑ Registered ❑ Return Receipt for Merchandise ❑ Insured Mail ❑ C.O.D. 4. Restricted Delivery? (Extra Fee) ❑ Yes 2. Article Number 7 012 1640 0000 119 6 9689 i (fransfer from service label) PS Form 3811. February 2004 Domestic Return Receipt • Complete items 1, 2, and 3. Also complete item 4 if Restricted Delivery is desired. • Print your name and address on the reverse so that we can return the card to you. • Attach this card to the back of the mailpiece, or on the front if space permits. 1. Article Addressed to::' WW 2. Article Number (Transfer from service la, A. Signature ❑ Agent X El Addressee B. Received by (Printed Name) C. Date of Delivery 5 - LI 102595 -02 -M -1540 D. Is delivery address different from item 1? ❑ Yes If YES, enter delivery address below: ❑ No 3. Service Type Certified Mail ❑ Express Mail ❑ Registered ❑ Return Receipt for Merchandise ❑ Insured Mail ❑ C.O.D. 4, Restricted Delivery? (Extra Fee) ❑ Yes ?012 1640 0000 1196 96 ?2 PS Form 3811. February 2004 Domestic Return Receipt 0 102595.02 -M -1540