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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 />1. Article Addressed to: <br />C,a� <br />4 <br />A. Signature' <br />❑ <br />X Agent <br />❑ Addressee <br />B. Rec'by-(Printed e) C. D of Alvery <br />D. Is delivery add ss dlfferent from hem ? 17Yes <br />If YES, enter delivery address below: ❑ No <br />3. Service lype <br />❑ Certified Mall ❑ Express Mail <br />❑ Registered ❑ Return Receipt for Merchandise <br />❑ Insured Mail ❑ C.O.D. <br />4. Restricted Delivery? (Extra Fee) ❑ Yes <br />2. Article Number 7011 0110 0002 1021 8333 <br />(transfer from service label) <br />PS Form 3811, February 2004 Domestic Return Receipt 102595 -02 -M -1540 <br />0 <br />4� <br />t91 <br />H <br />m <br />N <br />m mo <br />LL '.2 <br />m� <br />LLe <br />w <br />(�0 <br />LL <br />`a <br />f^; <br />�E <br />0� <br />�E <br />O <br />:C kp ii <br />• <br />C3 <br />NO <br />A <br />i�IL <br />� <br />¢w <br />Q, <br />`o <br />y ty iU <br />'IM <br />EEE9 220'1 <br />2000 OTTO <br />