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• Complete items 1, 2, and 3. Also complete <br />Rem 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 maiipiece, <br />or on the front if space permits. <br />1. Article Addressed to: <br />f)e,A�,( -9 1 Lo 60 6y10 <br />0 Agent <br />y <br />B. Received by (Printed Name) C. Date of Delivery <br />1? 0 Yes <br />D. Is delivery address di11 <br />ftem <br />,If YES, enter delive y adid�r s0, IOW' 0 N° <br />•t t v d,�r�f <br />3. SerOiCe Type i <br />❑ Ce ed Mail ❑) express Mail <br />C7 Reglste 10 Ratu �iPt for Merchandise <br />O Insured Mal4 D ,,2Q, 0.D• <br />4. Restricted Delive (Extra Fee) ❑Yes <br />2, Article Number 7 011 0110 0002 10 21 8 517 <br />p- ranS%r from service kW 102595.02 -M -1540 <br />Domestic Return Receipt <br />PS Form 3811, February 2004 <br />U.S. Postal Service <br />i,, <br />CERTIFIED <br />MAILT11 RECEIPT <br />(Domestic Mail OWY; <br />nice coverage Provided)— <br />NO Insura- <br />m. <br />171 <br />0-1 <br />$•70 <br />p <br />Postage <br />rq <br />Certified Fee <br />$3• - <br />0 <br />U <br />ru <br />O <br />C3 <br />Return Receipt Fee <br />(Endorsement Required) <br />$2.70 <br />APR 117' Y <br />0 <br />Restricted Delivery Fee <br />(Endorsement Required) <br />$0,00 , <br />C3 <br />, IC <br />V <br />r-3 <br />rq <br />Total Postage & Fees <br />$ $6.70 <br />O <br />Sent To <br />O <br />°= ------ ..l.- <br />S`tieef, ,opt 0'. 7 (' Q U-� J�.� /4 /- <br />or PO Box No �a7 �-- �1',Y'- -S 8-5 ... - 7 <br />f- <br />Crry, State. ZJP +4 <br />+� ,-�. c <br />rS L <br />• Complete items 1, 2, and 3. Also complete <br />Rem 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 maiipiece, <br />or on the front if space permits. <br />1. Article Addressed to: <br />f)e,A�,( -9 1 Lo 60 6y10 <br />0 Agent <br />y <br />B. Received by (Printed Name) C. Date of Delivery <br />1? 0 Yes <br />D. Is delivery address di11 <br />ftem <br />,If YES, enter delive y adid�r s0, IOW' 0 N° <br />•t t v d,�r�f <br />3. SerOiCe Type i <br />❑ Ce ed Mail ❑) express Mail <br />C7 Reglste 10 Ratu �iPt for Merchandise <br />O Insured Mal4 D ,,2Q, 0.D• <br />4. Restricted Delive (Extra Fee) ❑Yes <br />2, Article Number 7 011 0110 0002 10 21 8 517 <br />p- ranS%r from service kW 102595.02 -M -1540 <br />Domestic Return Receipt <br />PS Form 3811, February 2004 <br />