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■ Complete items 1, 2, and 3. Also complete
<br />item 4 if RestrlotAd,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: ff /
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<br />0 Agent
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<br />C. Date of Delivery
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<br />D. Is delivery address dfferent from item 1?
<br />0 Yes
<br />If YES, enter delivery address below:
<br />❑ No
<br />�J 3. Service Type
<br />�Vr tl n J Ltj Cj L7 (o 0 Certified Mall 0 Express Mail
<br />0 Registered 0 Return Receipt for Merchandise
<br />0 Insured Mail 0 C.O.D.
<br />4. Restricted Delivery? (Extra Fee) 0 Yes
<br />2. Article Number 7 011 01,1, 0 0002 10 21 8364
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<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: /
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<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.
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<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: /
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<br />A. Slcjnatute
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<br />B. Received by( Printed Name) C. Date of Delivery
<br />D. Is delivery address different from Item 1? ❑ Yes
<br />If YES, enter delivery address below: /NQO
<br />3. Service Type
<br />C 0 Certified Mail 0 Express Mail
<br />c.- � t G b� o f fl c �O 0 Registered 0 Return Receipt for Merchandise
<br />` 0 Insured Mail 0 C.O.D.
<br />4. Restricted Delivery? (Extra Fee) 0 Yes
<br />2. Article Number 7 011 0110 0002 10 21 8357
<br />(Transfer from servloe label)
<br />PS Form 3811, February 2004 Domestic Return Receipt 102595 -02 -M -1540
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<br />B. Received by( Printed Name) C. Date of Delivery
<br />D. Is delivery address different from Item 1? ❑ Yes
<br />If YES, enter delivery address below: /NQO
<br />3. Service Type
<br />C 0 Certified Mail 0 Express Mail
<br />c.- � t G b� o f fl c �O 0 Registered 0 Return Receipt for Merchandise
<br />` 0 Insured Mail 0 C.O.D.
<br />4. Restricted Delivery? (Extra Fee) 0 Yes
<br />2. Article Number 7 011 0110 0002 10 21 8357
<br />(Transfer from servloe label)
<br />PS Form 3811, February 2004 Domestic Return Receipt 102595 -02 -M -1540
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<br />B. Received by( Printed Name) C. Date of Delivery
<br />D. Is delivery address different from Item 1? ❑ Yes
<br />If YES, enter delivery address below: /NQO
<br />3. Service Type
<br />C 0 Certified Mail 0 Express Mail
<br />c.- � t G b� o f fl c �O 0 Registered 0 Return Receipt for Merchandise
<br />` 0 Insured Mail 0 C.O.D.
<br />4. Restricted Delivery? (Extra Fee) 0 Yes
<br />2. Article Number 7 011 0110 0002 10 21 8357
<br />(Transfer from servloe label)
<br />PS Form 3811, February 2004 Domestic Return Receipt 102595 -02 -M -1540
<br />5
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