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<br />°m SENDER: <br />a •CamPtete items 7 erM/or 2 for adtliliorral cenicea. ~ r <br />~ + I also wish to receive the . <br />m .Compete items 3, 4a, end 4b. 1011owing servIC6S (tor an <br /> • Pdnl your name and eddreae on me revere9 of Ihie loan so Ihet we cen rMum Ihi9 e%Ifa fee): <br /> <br />~ certl to you. <br />•Atlach fMS brm to the hoot of the maapiece, or on the back if apace tloes not <br />i <br />1. ^ Addressee's AddrBSs <br />~ <br />o p•mn <br />l. <br />•Wdte'Retum Reoaipf Fequesfed'on the mailpiece below the anicla number <br />2. ^ Restdded Delivery Y <br />y <br />,.C• •TTe Retum Receipt rill show to whom the editle was tlalivered end the date t1 <br />~ delivered. Consult postmaster for fee. <br />01 <br />0 <br />a 3. Article dressed to: 4a. Article Number m <br />m J~ f'~dt v/to ~-e 2 IQ2 l 2v 9~ <br />~g-~/~ Consl-vl,(~-5-(~,~y( <br />~d <br />O~ <br />~ 4b. Service Type v <br />S ~ ~ <br />' <br />" ^ Registered ^ Certified <br /> iz 7oc1 C2 195A~ <br />^ Express Mail ^ Insured <br /> <br />m <br /> ~I~CI_ CO g~'ZO I <br />~ <br />l ^ Retum Receipt for Merchandise ^ COD <br />o - <br />, 7. Date of Delive ~ 0 <br /> ~ <br />T <br />~ 5. Received By: (Print Name) 8. Adtlressee'S Address ( my i1 requested ~ <br />W and lee is paid) c <br /> ~. <br />~ 6. Signatur (Addres ee or nt) <br />o <br />' X <br />~ i~M~'- <br />O <br />PS Form 3811, December tssa Domestic Return Receipt <br />- + <br />Z 192 12~•~~•1'.~= <br />US Postal Service ~ ~ (; I r f~Y <br />Receipt for Certil?ted Mait-'•` ~ -" <br />No Insurance Coverage Provided. n <br />i <br />C <br />C <br />0 <br />C <br />I <br />i <br />[ <br />[ <br />Uo not use ror m[emaoonar mai aee rovcrse - - <br />tto7F'FC 21D moR <br />r1~Clm r) Sn <br />.Street 8 Number <br />1z7c~4 Cl2 f95.4 <br />post Ofrwe, Slate, 8 ZIP Cotla <br />o O 120 <br />' Postage $ <br />Certified Fee <br />Spedel Derivery Fee _ <br /> e tt <br />ResidcTed Delivery Fee ~'rJ . L <br />~ ReNm Fleceipl _ <br />' Whom 8 Date Defivere <br />F Fleeun RssNt StoM4 b <br />• Date,6Aa0essee's <br />I TOTAL Postage 6 Fees <br />1 <br />( <br />! Postmarks Date <br />~ I <br />~ <br />I <br />`~ <br />I <br />t <br />a <br />7 <br />D <br />7 <br />O <br />