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::USTOMER USE ONLY <br /> FROM:(PLEASE PRINT) PHONE(��) � � _ II��II IIIIII III III I III I I II II <br /> . - .t , III IIIIIIII I II <br /> 1v� ;�1Z7�1 c-V EK 3023407LO US <br /> BOX <br /> UNITEDSTATES PRIORITY <br />!AYMENT BY ACCOUNT(if applicable) V-.92- PISERVICE® EXPRESSTM <br /> USPS"Corporate Acct. No. Federal Agency Acct.No.or Postal Service'"Acct.No. <br /> @f1A1� <br /> •• • •nly) nPIGIN(PORTAL SERViCF.USE ONLY) <br /> ElSIGNATURE REQUIRED Note:The mailer must check the"Signature Required"box 1the mail 1-Day \❑2-Day ❑Military ❑DPO <br /> Requires the addressee's signature;OR 2)Purchases additional insurance;OR 3)Purchases COD service; �i' <br />'urchases ReturnReceipt service.If the box is not checked,the Postal Service will leave the item in the addr si•0ys PO ZIP Code Schedul Delivery Data Postage <br /> nail receptacle or other secure location without attempting to obtain the addressee's signature on delivery. <i <br /> Delivery Options <br /> Saturday <br /> ,`/y., <br /> ❑No Saturday Delivery(delivered next business day) 1 * I ..� $ <br /> ❑Sunday/Holiday Delivery Required(additional fee,where available') Date A pled(M Scheduled,Deli" Time Insurance Fee COD Fee <br /> ❑10:30 AM Delivery Required(additional fee,where available') <br /> 'Refer to USPSS com®or local Post Office"for availabili ❑10:30 AM 7N:i:00 PM $ $ <br /> TO:(PLEASE PRINT) ❑12 NOON I�VV <br /> PHONE( ) Ti pte f 10:30 AM Delivery Fee Return Receipt Fee Live Animal <br /> Transportation Fee <br /> Weight y lat Rate Sunday/Holiday Premium Fee Total Postage 8 Fees <br /> }X. V Y/ Acceptance s ///�� <br /> , � lbs. : -S. $ /JS ,�I ./"•� <br /> ✓ 1 <br /> ZIP+4"'(U.S.ADDRESS ONLY) <br /> Delivery Attempt(MM/DD/VY) Time Employee Signature <br /> El AM <br /> ❑PM <br /> t For pickup Or USPS TrackingT",Visit USPS.cor11 or call 800-222-1811. Delivery Attempt(MM/DD/Yl') Time Employee Signature <br /> t $100.00 insurance included. ❑AM <br /> ❑PM <br /> LABEL 11-B,JANUARY 2014 PSN 7690-02-000-9996 2-CUSTOMER COPY <br />