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• Complete items 1, 2, and 3. Also complete A. Signature_ <br />item 4 if Restricted Delivery is desired. ❑ Agent <br />• Print your name and address on the reverse Addre . <br />so that we can return the card to you. 1B. Received by (Printed Narr�e) C. D e of Wi <br />• Attach this card to the back of the mailpiece, )��/ y �� l�. <br />or on the front if space permits. � <br />D. Is delivery address different from item 11 11 Yes <br />1. Article Addressed to: If YES, enter delivery address below: ❑ No <br />1-°y /Q'? <br />drtd V, ` <br />UNITED STATES POSTAL,SERVICE - First -Class Mail <br />Postage & Fees Paid <br />USPS <br />Permit No. G -10 <br />• Sender: Please print your name, address, and ZIP +4 in this box • <br />CCU <br />�2 / <br />lam/ 3 <br />3. Service Type <br />❑ Certified Mail <br />❑ Express Mail <br />❑ Registered <br />❑ Return Receipt for Merchandise <br />❑ Insured Mail <br />❑ C.O.D. <br />4. Restricted Delivery? (Extra Fee) ❑ Yes <br />2. Article Number <br />?013 10 9 0 <br />0001 8 8 4 7 <br />510 <br />(Transfer from service labe <br />I PS Form 3811, February 2004 <br />Domestic Return Receipt <br />102595 -02 -M -1540 <br />UNITED STATES POSTAL,SERVICE - First -Class Mail <br />Postage & Fees Paid <br />USPS <br />Permit No. G -10 <br />• Sender: Please print your name, address, and ZIP +4 in this box • <br />CCU <br />