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• Complete items 1, 2, and 3. Also complete <br />item 4 if Restricted Delivery is desired. <br />• Print your name and address on the reverse <br />so that we can return the card to you. <br />• Attach this card to the back of the mailpiece, <br />or on the front if space permits. <br />1. Article Addressed to: (' <br />Clot <br />g 1S <br />-z- C) <br />A. Signature <br />X �I r , ✓ � I �� �✓ <br />c7resti <br />❑ dddr6 <br />W <br />B. Received by ( Printed Name) <br />1peturn Receipt for Merchandi., <br />ate of Delive <br />❑ C.O.D. <br />-W/ <br />D. Is delivery address different from item 1? ❑ Yes <br />If YES, enter delivery address below: <br />❑ No <br />3. Service Type <br />[Certified Mail <br />❑ ress Mail <br />❑ Registered <br />1peturn Receipt for Merchandi., <br />❑ Insured Mail <br />❑ C.O.D. <br />4. Restricted Delivery? (Extra Fee) ❑ Yes <br />2. Article Number - <br />Mransfer from service label) 91 7108 2133 3939 317 9 5 514 <br />PS Form 3811, February 2004 Domestic Return Receipt 102595-0244 -tE <br />• Complete items 1, 2, and 3. Also complete <br />item 4 if Restricted Delivery is desired. <br />• Print your name and address on the reverse <br />so that we can return the card to you. <br />• Attach this card to the back of the mailpiece, <br />or on the front if space permits. <br />1. Article Addressed to: <br />C 1 <br />e <br />2. Article Number - <br />(Transfer from service label) <br />PS Form 3811, February 2004 <br />X Sign ! ❑ Agent <br />dre <br />!!` <br />�1 Address <br />B. Received by (Printed Name) C. Date of Delive <br />D. Is delivery address different from item 1? ❑ Yes <br />If YES, enter delivery address below: ❑ No <br />3. rs Ice Type <br />L�l Certified Mail [;,Express Mail <br />❑ Registered ti Return Receipt for Merchand <br />❑ Insured Mail ❑ C.O.D. <br />4. Restricted Delivery? (Extra Fee) ❑ Yes <br />91 7108 2133 3939 0029 4321 <br />Domestic Return Receipt 102595 -02-W <br />