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N\AC, <br />NI I9 c54 —U i 3 <br />CeAl Ti ej� M aj, <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 />V�c��s t-G flo -?sn�C <br />Slop t S . "�5ro� <br />L.• t�l��nr C.� gvt a <br />A. SMure A. p El Agent <br />. - e" ❑ Addressee <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: ❑ No <br />3. Sep a Type <br />I� Certified Maile ❑ Priority Mail Express- <br />13 Registered ❑ Return Receipt for Merchandise <br />❑ Insured Mail ❑ Collect on Delivery <br />4. Rac+rinf.A rlcri.,e ,o <br />—. -. _ • ••••� L i Yes <br />Z. MUM Number <br />(Transfer from service label) 7 010 1060 — 000 -- 1 0936 6422 <br />PS Form 3811, July 2013 Domestic Return Receipt <br />rj-J <br />tiNPl/tI:�YIUli7fsl/ loll/ l' MCh) <br />f/ I; Yf /i:LiK:l�f�]!:I/:TiG)ari] %UC�i <br />ru <br />pp r' <br />M <br />n- <br />° <br />Postage: <br />_- , $0.48 <br />r3 <br />ED <br />Certified Fee: <br />v SM6143.30ic <br />C3 <br />(Er Return Receipt Fee: ;� ' "°° $2.70 <br />° <br />° <br />R <br />(Er Total Postage & Fe <br />at $6.48 <br />..0 <br />° <br />1 ..... ..., y ,... _ r w <br />11 <br />r <br />rq <br />Sent To <br />Street, <br />rK----- - - - - -- <br />C3 <br />or PO Box No. <br />5-('01 <br />5 = �-� <br />r`- <br />--- -- ------ . - - <br />City, State, ZIP +4 <br />-- <br />IIIII, Pb Form 38UU. August 2UU6 tiec Reverse Ion Instructions I <br />