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~~ 9y=o~ ~ <br />~' SENDER: <br />•Compla• it•m• 1 •ndor z for •ddtiona serNU•. I also wish to receive the <br />• •Compa• item. a, a•, end ~b. foNowiiig services (fa an <br /> .Prim your name end eddrese on the nvase of this form ao Net we pn ream the exits fee): <br /> cad to you. <br />~ •M.WI Ihie form to iM hoe of IhB mellpiece, Oran the beds a epau dose not 1. ^ Addfa556e'9 Addfeee <br />~• Mme. <br />eWd1e'Faum Receipt Reque•red'an the nialpbce babes the anitle numbs. <br />•TM Retum Receip will chow to when the Nida wee defvared end the tlae <br />2. ^ RBStflded DBIiVery <br /> <br />dWvered. <br />Consult postrnester for tee. tl <br /> <br /> <br />~ ~ ~3. ArCCIe Addressed to: <br />tl <br />~ <br />~ <br />d 4a. Ardde urnb r <br />3 ~ ~~3 S© <br />a ~a- <br />- <br />ri keZ <br />o <br /> (7 © i~~ ~ <br />U_ SO~ 4 Service Type <br />^ Re <br />istered ^ Certifled ~ <br />~ <br /> g <br /> ~D ~ S ~ O ~ ~ ^ Express Mail ^ Insured ~ <br /> ^ Retum Receipt for Merchandise ^ COD ~ <br /> 7. Date of Delivery ~~ ,!Q\ <br />'i o <br />0 <br /> T <br /> 5. Receiv By: (Print m 8. Addressee's Adtlress (Only i! requested ~ <br /> ~ end /ee is paid) ~ <br /> <br />g 6. ignature: (Addressee or ant) <br />i. X <br />w <br />PS Form 3811. December 1994 <br />1025959]-8-01]9 Domestic Retum Receipt <br />P 436 7B3 504 ~ ~. <br />US Postal ServMS ~ ~ j <br />Receipt for Certified <br />~ ~ <br />Mail <br />~ <br />No Insurance Coverage Provided. J7 ~ <br />Do nor use for Int <br />, <br />em <br />Sent o afionaf Mail See rave <br />~ <br />Ol'Q <br />~ ~~ kPZ <br />P t Dxios, Slate, 8 ZI vJ ~ ~ <br />OAJS <br />Postage <br /> ~,- 3 i <br />CerMetl Fee _ ~ J <br /> <br />Spedal Delivery fee ~ G <br /> <br />"Li <br /> <br />Resmded Delivery Fee . <br />,\' <br />' ,. ~ <br />'' a <br />~ Retum Receipt Showing to <br />_~ WMm d Date Delivered a <br />L C , o .~ <br />n Recim Recgq et <br />Dale <br />8 Mh <br />• ~ <br />~' r~ <br />O <br />, <br />essee <br />~ ,) <br />~ TDTAL Postage d Fees a ~ <br />~ ~ <br />Posenark or Date " ~'~ <br /> ~R <br />