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o :aENDER: <br />o •Complete itsma 1 and/or 2 for atldliond services. <br />m .Complete items 3, 4a, and 4b. <br />~ • Pdnl your name and edtlreea on the reverse of Ihie lone so Ihet we can return lhla <br />wtl to you. <br />j •Amach Mie loan to the iroM of the mailpiece. or on the baUc it specs does nq <br />~ permit. <br />m • Wdte'Rerum Receip( Requested' on the mailpiece bNOw the edicle number. <br />•Tlre Return Receipt will show to whom the eniae was delivered antl the date <br />C delivered. <br />m ~ rticle Addressed <br />t <br /> _ <br /> <br />a ` <br /> <br />ii 7'~ ~y ,~ <br />tJLJ~ <br />~ <br /> V <br /> <br />0 <br />0 <br />Z <br />~ 5. Received By: (Pdn <br />w 1 <br /> _ <br />?\n ~.. <br />e 6. Signatyra:_L4ddres <br />l <br />r i,'~ <br />X <br />N <br />Vv(J~ <br />tName <br />see or Agertt) .' <br />PS Fonn 3811, December 1994 <br />Z 130 ^8b.' 770_-sr~. <br />US Postal service <br />Receipt for Certified Mail <br />No Insurance Coverage Provided <br />Don use for Intemagonal Mail See reverse <br />Sent _! <br /> `A <br />r` <br />b rfu <br /> <br /> ice, Slate, 8 Code G <br />, .-n(~ <br /> J pn <br />r Postage ~ <br /> <br /> <br />CerCfietl Fee <br />Spedel Dtlivery Fee <br />Restricted Des as ~ '"i. r <br /> <br />Return Receipt Stwwng to 9 <br />l~ ~ <br />Wtxsn 6 Date Deivered ~ <br />Relum <br />~~ C <br />Dak,B ~ <br />TOTAL P ga d Fees a _~ <br />Postrnark or to ~ I <br />VSPS ~ <br /> <br /> "'"~ <br />_m <br />c <br />Q <br />O <br />M <br />lL <br />a <br />I also wish ro receive the <br />fdbwing services (for an <br />eMra tee): <br />u <br />1. ^ Addressee's Address <br />Z <br />2. ^ Restricted Delivery in <br />Consult postmaster for tee. ~ <br />d <br />4a. Article Number v <br />7 l ~P1 ~~n 7 7~ <br />b~'.Service Type <br />d <br />^ Registered Certified ~ <br />m <br />^ Express Mail ^ Insured ~ <br />m <br />^ Return Receipt for Merchandise ^ COD <br />7. Date of Delivery E <br />s-r-~ <br />8. Addressee's Address (Only i/requested ~ <br />and lee is paid) t <br />rr l1__ <br />~Ql <br />7 <br />a <br />n <br />7 <br />7 <br /> <br /> <br />