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SECTIONSENDER: COMPLETE THIS SECTION COMPLETE THIS DELIVERY <br /> ■ Complete items 1,2,and 3. M�W�'Pz <br /> [3 Agent <br /> ■ Print your name and address on the reverseso that we can return the card to you. ❑Addressee <br /> ■ Attach this card to the back of the mailpiece, eived by( rin Name) C. Date of Delivery <br /> or on the front if space permits. ��' <br /> 1. Article Addressed to: D. Is delivery address diff Item 1? ❑Yes <br /> If YES t � elow: ❑No <br /> Lexon Insurance Company R <br /> Shawn Neal 2 01�U <br /> 12890 Lebanon Road A�P��jO <br /> - i t TN 37122-2870 Y/f� TP, <br /> Mt. Jule , _ CIAO <br /> I I IIIII I III II I i l i I I II I I II II I I I I I I I 3. Service Ylika ❑Registered <br /> Mail 1 ail"m s® <br /> ❑Adult Signatu ❑Registered MaiIT"' <br /> ❑Adult Signature Restricted Delivery ❑Registered Mail Restricted <br /> 9590 9402 3488 7275 7578 61 0 Certified Mail® Delivery <br /> ❑Certified Mail Restricted Delivery ❑Return Receipt for <br /> ❑Collect on Delivery Merchandise <br /> 2. Article Number(Transfer from service label) ❑Collect on Delivery Restricted Delivery ❑Signature ConflrmationT <br /> ❑Insured Mail ❑Signature Confirmation <br /> 7 016 2 710 0000 2965 2253 ❑Insured Mail Restricted Delivery Restricted Delivery <br /> (over$500) <br /> PS Form 3811,July 2015 PSN 7530-02-000-9053 Domestic Return Receipt <br />