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o SENDER: I also wish ro receive the <br />9 •COmgele Mama 1 anNor 21or rrdditlorel eerskee. <br />e •Comgete items 3, 4e, and ~~. fdlOWrn s0rVIC03 (rot aft <br />o •pdrd your name erM address an tM revue of this bon a that we can velum tNe 0X12 fe0): <br />wN to you. Q <br />•Atlech Ihie lorm W 1M hoot of tM meilpiece, or on tM bark it cpece dose na y. ^ Address00's Addr05e ~ <br />~ WmY1. Y <br />el • Wdle'Refum Receipt Requested' on the mellpiau baba tlra article number. 2. ^ RBStdc[ed DB(iVery y <br />fj •The Relum Recelq will slaw to whorrl Vie snide wee delivered end the dale ~ <br />~ delivered. Consult postmaster for fee. <br />o <br />v 3. Article Addressed te~ 4a. Artlde Number L <br />o ryl~ II n ~ 7~ 7 ~ ~ E <br />a IrV~• tJ~l~, ~ <br />B ~ ~ _ _ 4b. Service Type S <br />$ ~ ~L~ (~~ ^ Registered ~Certifled <br />lft/1 ~r <br />^ F~cpress Maii ^ Insured ~ <br />a <br />^ Retum Receipt for Merchandise ^ COD <br />S S 7. Date of Delivery .. i <br />T <br />~. ~I c~ ° <br />5. Received By: (Print ) 8. Adtlressee's Address (Only it requested ~ <br />< ~ C L>/~ and lee is paid) r <br />/~U°N ,~/c Y1/~ ~7Z ~ <br />'j 6. 'gnetJre: Addresseed~ enfj <br />PS Form 3811, Dace 199 1025959],8-01]9 Domestic eturn Receipt <br />m <br />rn <br />rn <br />O <br />O <br />M <br />0 <br />LL <br />m <br />a <br />P 436 777 ~'~_S <br />US Postal Service ---v~~~-0Y„~ <br />Receipt for Ctt~a,•~---- <br />No Insurance Coverage Provided. <br />Do not use for International Mail lSee reversel"'1 <br />tl~l r. C..Su rYrMers <br />T I.J L <br /> <br />Pos(a se. State, 8 ZIP Cgde / O r <br />jj <br />Postage ~ $ '~ <br />Certified Fee /', _/ U <br />Spaoel Delivery Fee <br />Restricted Delivery Fee <br />Rehm R Iq <br />Wham b l.~ ,/] <br />.f- <br />ReLm m <br />Dare, r se's d0 <br />v <br />TOTA4 P <br />Poslm A Oro <br />S ~ <br />- <br />