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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 mailplece, <br />or on the front if space permits. <br />1. Article Addressed to: <br />3arr% D'A�3�1 <br />�_. O. l -Sox /09 i <br />�R /.S Z-O <br />A. Signature <br />❑ Agent <br />❑ Address <br />B. R slued by (Printed Name) C. Date of Delive <br />i" <br />/ <br />D. Is delivery address different from item 1? ❑ Yes <br />If YES, enter delivery address below: ❑ No <br />3. Se5oce Type <br />Certified Mail ❑ ress Mail <br />13 Registered m Receipt for Merchandi: <br />❑ Insured Mail ❑ C.O.D. <br />4. Restricted Delivery? (Extra Fee) ❑ Yes <br />2. Article Number <br />(Transfer from service labeo 91 ?108 2133 3939 0 0 2 9 42?? <br />PS Form 3811, February 2004 <br />Domestic Return Receipt 102595 -02 -M -1.' <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- O. <br />❑ Agent <br />��- Ad <br />Received by (Prfn d Name) C. at f ell <br />r iii; <br />D. Is delivery address different from Item/1? Q Yes <br />If YES, enter delivery address below: ❑ No <br />3. Service Type <br />1�r&rtifled Mail ❑ Ewess Mail <br />❑ Registered Weturn Receipt for Merchandi; <br />❑ Insured Mail ❑ C.O.D. <br />4. Restricted Delivery? (Extra Fee) ❑ Yes <br />2. Article Number <br />(rransfer from service label) 91 ?108 2133 3939 317 9 5569 <br />3S Form 3811, February 2004 Domestic Return Receipt 102595-02 -M -15 <br />