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~ SENDER: <br />v Complete items t ardor 2 for additional services. <br />n •Complela items 3, 4a. and db. ' <br />~ • Prinf your name antl address an the reverse of this form so Nal we can return this <br />card to you. ' <br />i •Mach Chia form to the horn of Ina mailpiece, or on the balk tl space does rat <br />pBrmit. <br />y • Wdfe'Aefum Receipt Requested'on the mailfaece below the aniGe number. <br />~ •The Return Receipt well show to whom the aniGe was tlellvered Bntl the dale <br />~ deliveretl. <br />O <br />GG ~'"" <br />o n?L~1l~S2_. ~ g~a`~~ <br />I also wish to receive the <br />following services (for an <br />extra fee): <br /> <br />1. ^ Addressee's Address u <br />~ <br />2. ^ Restricted Delivery y <br />Consult postmaster for fee. <br /> Y <br />~ef3~l`1 Oz'1 ~ . <br /> <br />rpe ~ . <br />m. <br />^ Registered ~Cert'fied_ m <br />^ Express Mail ^ Insured ~ c <br />N <br />^ Retlun Receipt for Merchandise ^ COD <br />7. Dat of De very <br />SAddress (Only i/requested ~ <br />~ TSlgha~ : (Ad asses or <br />r X ~, <br />m <br />PS Fomi 3811, December <br /> <br />and /ee is paid) t <br />r <br />F 47 027 <br />C IFIED MAIL '~ <br />G VERAGE PROVIGEG <br />Sp® ~ ~ NTERNAiIONgt MAIL <br />~" y (See Reversal <br />jy to <br />°o rp~ tlN ,1. <br />Y'~r <br /> <br />O <br />a .Slate n ZIPC <br />tl <br />N <br />~ Postage <br />•. 5 <br /> Cenifie e <br /> Spec r <br />' <br /> • <br /> Reslnd er <br /> Return Rec i ~Sho <br />r <br /> to whom and Date Delivered y <br />of <br />T Return RECeipl showing Io whom. ~ ` <br /> <br />d Dale. and Address of Delivery ~ <br /> <br />j <br />TOTAL Postage and Fees <br />S ~ <br />7 <br /> <br />L Postmark Or Dale - <br />'r i <br />E <br />p ~J <br />L <br />n <br />L <br />