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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 />'nl Q I I 0 <br />9 15 �b <br />2. Article Number <br />(Transfer from service label) <br />DS Form 3811, February 2004 <br />A. Signature <br />X X ❑Agent <br />err ❑ Addresse <br />B. Received by (Printed Name) C. ate of Delivei <br />D. Is delivery address different from item 1? ❑ Yes <br />If YES, enter delivery address below: ❑ No <br />3. Se Ice Type <br />Eff Certified Mail <br />❑ rasa Mail <br />❑ Registered <br />Retum Receipt for Merchandi: <br />❑ Insured Mail <br />❑ C.O.D. <br />4. Restricted Delivery? (Extra Fee) ❑ Yes <br />91 7108 2133 3939 2944 1911 <br />Domestic Return Receipt 102595-02 -M -15 <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 />J 0. Py-L es <br />A. Signature r,, <br />❑ Agent <br />r -'J <br />'❑ Address - <br />Received by Printed e) C. Date of Delive <br />. Is delivery address different from iterga 17 ❑ Yes <br />If YES, enter delivery address bel&n ❑ No <br />3. Se Type <br />rtified Mail ❑ Wress Mail <br />❑ Registered EpAetum Receipt for Merchandi: <br />❑ Insured Mail ❑ C.O.D. <br />4. Restricted Delivery? (Extra Fee) ❑ Yes <br />2. Article Number <br />(Transfer from service label) 91 7108 2133 3939 0 0 2 9 4291 <br />PS Form 3811, February 2004 Domestic Return Receipt 102595-02 -M -1; <br />