2017-04-10_REVISION - M1987164 (3)

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m . . . COMPLETE • ,�'gnature '(i Complete items 1,2,and 3. NP p Agent it Print your name and address on the reverse ❑Addressee so that we can return the card to you. g Received by(Print Name) C. Date of DeWery s Attach this card to the back of the mailpiece, t "LJ —9 or on the front if space permits. RECEI tyf E 1. Article Addressed to: D. Is delivery address different from item 1?If YES,enter delivery address below: 0 No No t\-k k cln-aeO 4Coin `0 2 c� iCJtxt t `P�se"'arr ation, a _ . r ��0 J I !Cu";cli .,;;? Safety "( � 3. Service Type ❑Priority Mail Express® I III III II II II I"III I III ❑Adult Signature ❑Registered Mal"II I'III�I I'II I'l l III I ❑Adult Signature Restricted Delivery ❑Registered Mail Resttcted certifierd Mallet Delivery � ❑Certified Mali Restricted Delivery ❑Return Receipt for 9590 9402 1217 5246 1939 77 Merchandise ❑Collect on Delivery ❑Signature ConfinnationT°" ranSfel from SerYice label) Collect on Delivery Restricted Delivery ❑mature Confirmation 2.. Article Number(r Aail Restricted Delivery 7 015 1520 0000 9895 8693 Asil Restricted Delivery >o l°S Form 3811,July 2015 PSN 7530-02-Wo-9053 Domestic Return Receipt Postal CERTIFIED oRECEIPT frl Domestic Only c0 Ir Certified Mail Fee CO g F _.. 117 Extra Services&Fees(check box,add fee W eppropdata) =�CHere Q 6 5� 0'R,4 ❑Return Receipt(hardcopy) $ 'R C3 ❑Return Recelpt(eiectmnic) $ � O ❑Certified Mail Restricted Delivery $ - Tfl Q Adult Signature Required $ Adult Signature Restricted Delivery$ - p Postage 4i ru G' Total Postage and Fees ^ J�r�,f,��{C r-9 r 11 S u-) Sent T rq �c kA lylyl& --------- ----- - - O sheer a t.No r I3ox No: Nx 1� ------- -------------------=------------------- :.. WAIN .. .