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~• SENDER: <br />9 •Com0lete items 1 and/or 2 for atlditicnal services. <br />I x150 WISh to feCeiVe the <br />a •COmDlete items 3, ba, entl 4b. fOIIOWIng SBrviC05 (fOr an <br />m • Prim your name and atltlress on the reverse of this brm so That we can return this extra f66): <br />W' ftl 10 yOU. <br />• Anach this term to the from of the mailpiece, or an the beck it space does not <br />t , ~ Addres5ee'S Address V <br /> <br />Z <br />~ permit. <br />y •Wdte'Aelum Receipt Requested'on the mailpiece below the oracle number. 2. ~ Restricted Delivery y <br />•The Relum Receipt will show to whom the enitla was delivered and the tlale <br />° <br />~ delivered. Consult postmaster for tee. ' <br />Y <br />~ <br />v 3. Article Addressed to: 4 . rtic y~11}rt <br />~ r <br />l~ <br />~ w <br />v~ n r'1 <br />~ <br />~ ~~ ~ G X w <br />W "l~ <br />i <br />~ <br />~ ~x.L/ <br />n <br />G^' <br />1N ~~ <br />e 4b. Service Type 1310 <br />' <br />r.. <br />v J <br />~ <br />a <br />.i ~ ^ Registered p(Certified <br />w p~ y~ <br />(w~, <br />~ <br />~ <br />, <br />il~Q.l.1 GCQ.O Q,~ I .ja. <br />^ Express Mail Insured <br />d ` <br />5 <br />A <br />¢ ^ Return Receipt for Melcftandise ^ COD <br />0 7. Date of Delivery f <br />Z _,z ~-9 r <br />~ a <br />5. Re~eived By: (Print N <br />me) <br />~ 8. Addressee's Address (Only i/requested ~ <br />W / <br />~ <br />~7 ~/ <br />AOS.C MnrY ~ /'!</ ~l~r~a1~ and Jae is paid) F <br />~ 6~g~re: (Adq/asses rAger(Adq/asses r/AJger <br />° `,, ~ i i / <br />N t a. <br /> <br />Ps Form 3811 (l77~cember tssa / uornesnc f-return necelpt <br />r <br />