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1 ' • <br /> CERTIFIED oRECEIPT <br /> Ln .. <br /> a <br /> ru , <br /> Ln <br /> Certified Mail Fee <br /> $ <br /> . . 3. <br /> fU Extra Services&Fees(check box,add fee as appropriate) <br /> ❑Return Receipt(hardcopy) $ <br /> O ❑Return Receipt(electronic) $ Postmark <br /> )_ ❑Certified Mail Restricted Delivery $ it{ Here - <br /> O ❑Adult Signature Requirad $ <br /> 0 ❑Adult Signature Restricted Delivery$ -'S,'•� <br /> l7 Postage <br /> rl $ <br /> r% Total Postage and Fees <br /> ti $ ?2 <br /> Sent To <br /> r9 street andApt.NO.,iw PO Box No:---------------------------------------------------- <br /> C3 <br /> City,State,ZIP+4� <br /> ------------------------------------------------------------------ <br /> x <br /> Certified Mail service provides the following benefits: <br /> ■A receipt(this portion of the Certified Mail label). for an electronic return receipt,see a retail <br /> ■A unique identifierfor your meilpiece-. associate for assistance.To receive a duplicate <br /> ■Electronic verification of delivery at -'return receipt for no additional fee,present this <br /> delivery. USPSO-postmarked Cerbfied Mail receipt to the <br /> ■A record of d8jW@leludin tl r'CIE retail associate. <br /> signature)that s retained y e S rvice '—Resurl Md delivery service,which provides <br /> for a spec'fii nod d to the addressee specified by name,or <br /> tmpdrta R�e addressee's authorized agent <br /> tstgnaturesery ice,which requires the \ <br /> ■You may p hase Ce t fled Mail se with gne to eatP21of age(not <br /> ss M Fust-Class Pac ry e®, a l e treor Priority Mail'ser�tes.. � gnery service,which <br /> ■Certified Mail service is note u l' eqmr the siast 21 years of age' <br /> Intema'ional mad. and provides delivery to the addressee specified <br /> ■Insura ce coverage is notavailable for purchase by name,or to the addressee's authorized agent <br /> with f artified Mall service.However,the purchase (not available at retail). <br /> of Ce•ified Mail service does not change the ■To ensure that your Certified Mail receipt is <br /> Insur,ice coverage automatically included with accepted as legal proof of mailing,it should bear a <br /> certai Priority Mail items. USPS postmark.If you would like a postmark on <br /> ■For an additional fee,and with a proper this Certified Mail receipt,please present your <br /> endorst ment on the mailpiece,you may request Certified Mall item 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 Certified Mail receipt,detach the barcoded portion <br /> of delivery Lneluding the recipient's signature). of this label,affix it to the mailpiece,apply <br /> You can r�lpq»�ra�A"rlty r approoriaiu�st�g�nddepgSlyheifp}@�e. <br /> electron icversi4 ��fal9cd)1 2dkr�WfitLt , Mi t�r(J �f(�jj <br /> complete PS Form 3811,Domestic Retum <br /> Receipt;attach PS Form 3811 to your mailpiece; IMPORTANT:Save this receipt for your retards. <br /> Ps Fonn 3800,April 2015(Reverse)PSN 7530-02.000-9047 <br />