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SENDER: COMPLETE THIS SECTION COMPLETE THIS SECTION ON DELIVERY <br /> ■ Complete items 1,2,and 3. A. Signature <br /> ■ Print your name and address on the reverse X ❑Agent <br /> so that we can return the card to you. ❑Addressee <br /> ■ Attach this card to the back of the mailpiece, B. Received by(Printed Name) C. Date of Delivery <br /> or on the front if space permits. <br /> D. Is delivery address different from item 1? ❑Yes <br /> Georgic Bistfell If YES,enter delivery address below: [3No <br /> Great American Insurance Company, <br /> 301 E. 4th Street <br /> 24th Floor Bond Division <br /> Cincinnati, 01145202 <br /> II"III'I IIII('I I II II'i I I II I II I IIII Ii�IIII�� 3. Service Type ❑Priority Mall Express® <br /> ❑Adult Signature ❑Registered Mad <br /> ❑,Adult Signature Restricted Delivery ❑Registered Mail Restricted <br /> 9590 9402 3488 7275 7597 42 Certified Mail® Delivery <br /> ❑Certified Mail Restricted Delivery ❑Return Receipt for <br /> ❑Collect on Delivery Merchandise <br /> 2. Article Number(Transfer from service iabeO ❑Collect on Delivery, fir <br /> Restricted Delivery ❑Signature Confirmation <br /> ❑Insured Mail ❑Signature Confirmation <br /> 7 016 2 710 0000 2965 4387 ❑Insured Mail Restricted Delivery Restricted Delivery <br /> ---- — I (over$500) <br /> PS Form 3811,July 2015 PSN 7530-02-000-9053 Domestic Return Receipt <br /> Certified Mail service provides the following benefits: <br /> ■A receipt(this portion of the Certified Mail Isbell. for an electronic return receipt,see a retail <br /> ■A unique identifier for your mailpiece. associate for assistance.To receive a duplicate <br /> ■Electronic verification of delivery r aftempt� return receipt for no additional fee,present this <br /> delivery. f ) r•ti(5 USPS®-postmarked Certified Mail receipt to the <br /> •A record of del di <br /> signature)that is ned by the Postal Service'" -Restricted delivery service,which provides <br /> for a specified ri � ,r- livery to the addressee specified by name,or <br /> Pe P_ � <br /> prized agent <br /> Important Rem! Adult signature service,which requires the <br /> ■You may purchase Certified Mall service with signee to be at least 21 years of age(not <br /> First-Class Mail°,First-Class Package Servicem, available at retail). <br /> or Priority Mail®service. Adult signature restricted delivery service,which <br /> •Certified Mail service is not available for requires the signee to be at least 21 years of age <br /> intemational mail. l S C �� and provides delivery to the addressee specified <br /> ■Insurance coverage is not available for purchase by name,or to the addressee's authorized agent <br /> with Certified Mail service.However,the purchase (not available at retail). <br /> of Certified Mail service does not change the ■To ensure that your Certified Mail receipt is <br /> Insurance coverage automatically included with accepted as legal proof of mailing,it should bear a <br /> certain Priority Mail items USPS postmark.If you would like a postmark on <br /> •For an additional fee,and with a proper this Certified Mall receipt,please present your <br /> endorsement on the mailpiece,you may request Certified Mail hem at a Post Office'for <br /> the following services: postmarking If you don't need a postmark on this <br /> -Return receipt service,which provides a record Certdied Mail receipt,detach the barcoded portion <br /> of delivery(including the recipient's signature). of this label,affix it to the mailpiece,apply <br /> You can request a hardcopy return receipt or an appropriate postage,and deposit the mailpiece. <br /> electronic version.For a hardcopy return receipt, <br /> complete PS Form 3811,Domestic Return <br /> p yp py�Realab>itlachi ' iem�enn " ' bomb enver,Cu`Zf6GV�#°C�ds <br /> Ps Fo"3388W,JAp-ril 2015(Reverso)PSN 7530-02-000.9047 <br />