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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 cans to the back of the mailpiece, <br />or on the front if space permits. <br />1. Article Addressed to: <br />7 <br />A. Signature <br />❑Agent <br />X l�, ❑ Address <br />B. eceived by (Printed ame) C Date of Delive <br />D. Is delivery address different from Item 1? ❑ Yes <br />If YES, enter delivery address below: ❑ No <br />3. Service Type <br />'Y �J E3 Certified Mail ❑ F praw Mail <br />L C ❑ Registeredietum Receipt for Merchandi: <br />O ❑ Insured Mail ❑ C.O.D. <br />4. Restricted Delivery? (Extra Fee) ❑ Yes <br />2. Article Number 91 710 8 213 3 3939 317 9 5545 <br />(Transfer from service label) <br />PS Form 3811, February 2004 Domestic Return Receipt 102595-02 -M -1E <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 />t'ynti,, U <br />�l 5 Z U <br />A. Si ture ++ <br />X ❑Agent <br />l; kj'— ❑ Address, <br />B. Receiv d by (Printed Name) C. Date of Delive <br />1-/1-/3 <br />D. Is delivery address different from item 1 ? ❑ Yes <br />If YES, enter delivery address below: ❑ No <br />3. Service Type <br />[Certified Mail ❑ ss 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 3179 5590 <br />(Transfer from service label) <br />PS Form 3811, February 2004 Domestic Return Receipt 102595 -02 -M -1E <br />