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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 />-- <' <br />1. Article Addressed to: <br />A. ignatu <br />❑ Agent <br />X J Z. N C—� ❑ Address <br />B. Received by (Printed Name) C. Date of Delive <br />l�L/Z% � • L C L <br />D. Is delivery address different from Item 1? ❑ Yes <br />If YES, enter delivery address below: ❑ No <br />3. Service Type <br />ffCertdW Mail ❑ Express Mail <br />❑ Registered Return Receipt for Merchandi; <br />❑ Insured Mail ❑ C.O.D. <br />4. Restricted Delivery? (Extra Fee) ❑ Yes <br />2. Article Number 91 7108 2133 3939 0029 4079 <br />(transfer from service labeq <br />=S Form 3811, February 2004 Domestic Return Receipt <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) 9 .ti ' <br />�T ✓�. �J Vl Cam. [� 0 C- O <br />8) ! o4- — f 14) <br />A. Signature <br />X <br />B. Received b Led Name) <br />D. Is ellirPr rQI <br />If Ekenter <br />1C <br />102595-02 -M -15 <br />❑ Agent <br />❑ Address - <br />C. Date of Delive <br />fn Item 1? ❑ Yes <br />lbelow: ❑ No <br />3. Service Type <br />Certified Mail ❑ press Mail <br />13 Registered I2 -alum Receipt for Merchandi: <br />❑ insured Mail ❑ C.O.D. <br />4. Restricted Delivery? (Extra Fee) ❑ Yes <br />2. Article Number 91 710 8 213 3 3939 0 0 2 9 412 3 <br />(Transfer from service label) <br />PS Form 3811, February 2004 Domestic Return Receipt 102595-02 -M -15 <br />