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<br />r 1 <br />~J <br />r.. <br />SENDER: <br /> <br />I nt Complete items 1 antllor 2 for atlditionel eervicea. I also wish to receive the <br />, <br />y Complete items 3, antl 4e ~ b 10110Wing aerVlOes Ilor Bn B%1rB N <br />u <br />to • Prmt Your name antl address on Ina revere of this loan so the[ wa can <br />1ee1: <br />m '` <br />return tnis card to you. <br />' ` • Attach this loan to the Iront al tna meilp~ece. or~pn the beck i t space 1. ^ Addressee's Address y <br />does no[ permit ' <br />d Wr~te"Return Receipt Repuested"pn the mailpieca below the art <br />icle numpnr. <br />2. ^ Restricted Delivery <br />6 <br />•m <br />• Tne Return Receipt will snow to whom the article was Uelwered end the date <br />t C delwerntl <br />o Consult ostmaster for }ee. m <br />v 3. Article Addressed io: <br />I Article Number //,~ ~ <br />n <br />~a,s SttY~ <br />' p lyc~~~ ~.,. 4b. Service Type <br />^ Registered ^ Insured er <br />~ <br />. <br />y ~~~\\~ ry n.~ ~~~C~ <br />11~ ertifled 1~ COD ~ <br />W 1 Rewrn Receipt for <br />^ Express Mad ~ ~ <br />~ Merchandise <br />~ ~ 7. Date of Delivery f <br /> o <br /> <br />2 5. Signature IAddresseel <br />8. Addressee's Address (Only if requested T <br />y <br />~ > and tee rs paidl ~ <br />i H <br />I Q 6. Signature IAgentl s <br />~ <br /> G~- ~ i, r I I <br />i > PS Form 811, December 1991 au.s.~PO;topz~x>wx DOMESTIC RETURN RECEIPT <br />i <br /> <br />