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~Complele items 1 andpr 2 for adtlidonel 6BfNC96. I aISO WISh t0 reCBIVB the <br />Complete items 3, Ia, arq Ab. fOIIOWing 59NICBS (fOr an <br />a~ n <br />t; ouru ame and address on Ne reverse of this knn so Ihal we can return this extra fee): <br />d <br />.Aaach (MS form to the hoot of the mail ace, or on the Dadc d <br />pi space does not <br />l <br />1. ^ Addre5566~5 Address ai <br />u <br />pemu <br />. <br />~ Wnte'Rerum Receipt Reguesfed'on the mailpiece below the article number. <br />2. ^ Restricted DeIlVery d <br />y <br />The Return Receipt will show to whom the elide was delivered and the tlale <br />delivered. <br />Consult postmaster for fee. <br />ii <br /> Y <br />3. Article Addressetl to: 4a. Article Number u <br />,,~~,,// ~~ <br />~ <br />~ <br />s <br />" <br />~ <br />~ 4b. Service Type <br />ER <br />^ R <br />i <br />t <br />^ C <br />rtifi <br />d <br />, <br />,,~y..r•..p.i <br />g,•.• <br />~ <br />.~ <br />'v <br />( <br />, eg <br />s <br />ered AV <br />e <br />e <br />, CQ ~ <br />` <br />n <br />~ <br />~d00 /~'c?!»r, <br />; ^ Express r' ST Insured ' <br />~ <br />P~ ~~ ^ Return ecei t for Me dl COD ~ <br /> <br />C 0 7. Date of :r 7c <br />m <br />iO '` f <br />g iG A T <br />5. Received By: (Pont Name) 8. Addressee Ad requested ~ <br /> and /ee is p 1 i <br /> r- <br />6. Signature: dressee or Age <br />X ~~~ <br />PS Form 3811, December 1994 Domestic Return Receipt <br />' <br />- <br />J~,~~ T- <br />p _ Z 434 941F~1~,9 <br />US Postal Service &~ <br />/g3 <br />Receipt for Certified Mat <br />.~ No Insurance Coverage Provided. <br />W Do not use for International Mail See reverse <br /> <br />~ <br />W Sent to <br />]-' <br />~ Slreetb Number <br />D <br /> yst <br />_yy rate <br /> 0. <br />l' g <br />f ~ <br />' <br />yX <br /> P <br />a5tag <br />e <br />fi~a C <br />\' Z <br /> <br />I7 l L <br />3 cemrea e '~, ~ ~ <br />v <br />~. <br />Spedal Deli <br />(~ <br /> <br />~ 'B4 <br /> Reslndad DeGve <br />' <br />" <br /> Return Receipt Showing to <br />Whom b Date Delivered Y <br />O! _J <br />,gyp PeNm Receipt Slnwig to Ydlorri, <br />' Q Date, b AdAessees Address <br /> <br />® TOTAL Postage b Fees s <br />~.,~, <br />~ Postmads m Data , <br />~ f <br />G <br />