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m SENDER: I also wish to receive the , <br />O • Complete items t and/or 2 for additional services. 1010WIng 50rvICeS (fOf 8n <br />Ta • Complete items 3, 48, and bb. <br />1 ` • Print your name eM address on the reverse of this roan so that we can return this <br />extra fee): <br />caN to you. <br />j ? rr Attach this form to the front of the meilpiece, or on the back it space does not <br />1. ^ Addressee's Address ,~i <br />Z <br />e permit <br />• Wdte 'Return Receipt Requested'on the mellpiece below the aNcle number. 2. ~ Restdded Delive <br />ry <br />~ , <br />w • The Return Receipt will show to whom the artide was delivered and the date C.Ollsun pOSt!llaste! f0! fee. ~ <br />delivered. _ <br />~~ 3. Article Atld~r~sad1o• 4a. Article N umber <br /> <br />Z ~-• c „r~ <br />~ /J 4b. Service Type ~ ~ <br />~ <br />J!D-C r <br />^ RegisteredCertified ¢ <br />//S~( ~_~~~ ~ ~ Express Mail ^ Insured c <br />' / ~-~\ ^ Return Receipt for Merchandise ^ COD ~ <br />L/~y~'r„q,~y~/ LJJ nb J 1, _ 7. Date Deli _ ry ~ f ' <br />ii' LCC 25 (~/f1.1 0 <br />i.• <br />5. Received By: (Print Name) 8. Addressee's Address (Only it requested m <br />and tee is paid) <br />6. Signs re: ( tlress e o Agent) <br />p Form 3811, December 19 tazsvs-sseozzs Domestic Return Receipt <br />__~~ <br />C <br />Ul- <br />4. <br />s' <br />M1 <br />O"' <br />A <br />Postage i $ <br />Return Receipt Fee <br />q (Entlorsemen[ Required) <br />O <br />p RestdIXad Delivery Fea <br />p (Endorsement Required) <br />O <br />f~- <br />.D <br />rl <br />1C1 <br />Q <br />4 <br />t~ <br />). <br />Denier, CO 80103 <br />