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COMPLETE •N COMPLETE THIS SECTIONON DELIVERY <br /> IK,Comptete items 1,2,and 3. A. Signature <br /> ■ Print your name and address on the reverse X n-Agent <br /> so that we can return the card to you. 4 ' - ❑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. r j. LIL j V q— <br /> 1. Article Addressed to: D. Is deliv m item 17 ❑Yes <br /> �n � k If YIR is below: ❑No <br /> e.x C°7 CCT 192021 <br /> 1 ltY ) c o 91 c)47 p►VISION OF RECLAhI°TICN <br /> III'lll' I'I ('IIIIIIIIIII��'II'llI IIIIIIIII 3. Service AyW ❑Regitered ail- s® <br /> ❑Adult Signature El Registered Mail*M <br /> ❑Adult Signature Restricted Delivery ❑RegIstered Mail Restricted <br /> 9590 9402 4401 8248 9097 04 ❑Certified Mail estricted Delivery ❑Rettiurn Receipt for <br /> ❑Collect on Delivery Merchandise <br /> 2. Article Number(Transfer from service laben ❑Collect on Delivery Restricted Delivery ❑Signature Confirmation^" <br /> Insured Mail ❑Signature Confirmation <br /> 7 018 2290 0001 8923 5081 'nsured Mail Restricted Delivery Restricted Delivery <br /> over$500) <br /> PS Form 3811,July 2015 PSN 7530-02-000-9053 Domestic Return Receipt <br />