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iiiiiiiiiiiiiiuiii <br />sss <br />~ SENDER: <br />o •Complale items 1 andor 2 for additional •erWcea. I also wish t0 feCeiVe the <br />m •COmplete items 3, da, and 46. ,1011owing SerVICBS (for 8n <br />w • Prim your name and etldress on the reverse of this Mrtn so Ih~we can Tatum Chia extra fee): <br /> tartl 10 you. <br />•Adacn this bnn to Iha hom of the mail lace, or an the back its ace tloee not <br />a p <br /> <br />1. ^ Adtlressee's Address m <br />~ <br />y •Wnte!Relum Receipt Requested'on the mailpiece Deiowthe anicle number. 2.^Resldcted Delivery tlj <br /> •The Relum Receipt will ehow to whom the enirJe was d•liveretl antl the dal0 «a <br />~ deiiveree. Consult postmaster for fee. •d <br />0 <br />0 <br />a 3. Article A ressed to: <br />~ ~~~ ~~~on 4a. Article Number <br />~ . i ~- ~.a~- u <br />c ~ ^~ ~ <br />I <br />JLJ 4b. Service Type <br />o .. ^ Registered Certified <br /> <br />vt <br /> <br />~ <br />^ Express Matt ^ nsured rn <br />m <br />¢ ^ Retum Receipt for Meahandi9e ^ COD <br /> <br />O ~~~~ 7. Date of Delivery <br />a ~ <br />z i, <br />~ 5. Received By: (Print Name) 8. Atldressee's Address (Only i/requested ~ <br />w and lee is paid) _ t <br />' <br /> r <br />~ 6. Si e: (Add ass a ar A enf <br />/ <br />e ~ <br />~ 1 <br />PS Fomn 3811, D camber lass Domestic Return Receipt <br />Z 19S~r5y1 (~~ <br />US Po P arvlc~ile ~I I~ <br />Recei t for ertffl a'I <br />No Insurance"Coverage Provided. ~ <br />Do not use for Intemetional Mail See reverse W <br /> <br />O <br />~E <br />LL <br />a <br /> • <br />l U <br /> 1 <br />8 urMe <br />osY , Stare, 6 ZIP a fy <br />, ~ ~ <br />Posm~ s 8Q,1 S <br />Cartlfied Fee ' , n <br />Spedal Delivery Fee v V <br /> <br /> <br />Fimldded Delivery Fes R <br />Return Receipt Showing m A r I <br />I m <br />Whom 8 Daro Delivered ~ <br />Resun Recepr C <br />Dale, 6 y <br /> C <br />TOT ees 's / C <br />P e~ Da ~ <br />~ ^h^ <br />GJ <br />7 \~j~ (~, <br />~Q <br />2~ <br />0 J <br />