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^ Complete items 1,~2, and 3. Also complete <br />item 4 if Restricted Delivery is desired. <br />^ Print your name and address on the reverse <br />so that we can return the card to you. <br />^ Attach this card to the back of the mailpiece, <br />or on the front it space permits. <br />t. Article Addressetl to: <br />~Clei~ d ~.t C'~i~ <br />~ 5 3 SQ~..~ - ~. <br />f~A 9~3kZ~ ~~~ <br />2. Article Number (Copy /rom service labeq <br />• ~`J~ /.3~7 ~,~ <br />PS Form 3811, July 1999 _ . " Obmesuc <br />^ Complete items 1, 2, and 3. Also complete <br />item 4 if Restricted Delivery i.+dCSired. <br />^ Print your name and address on the reverse <br />so that we can return the card to you. <br />• Attach this card to the hack of the mailpiece, <br />or on the front if space permits. <br />1. Artcle Atltlressed /to: 'l,\ /, / / <br />~~a ~ma,rd ~ `r-~'lnt'k~ l.hJr,sSck <br />1~.~ ~~/~ Q3~J,31 <br />2. Article Number (COpy7mm service label) <br />~• f59 •1~37'Z7~ <br />PS Form 3811, July 1999 <br />i- <br />159 :137 `283 <br />A. Way (Please ri, C ~ R. Xiate of Delivery ;rat SBrviCO <br />///tom :ipt for Certified Maii <br />_. Syna ure Irance Coverage Provided. <br />x7`. ~ p6G r ~ c- Gl l~ Agent use for In(emafional Mail See reverse <br />aN Aildressee . I <br />D. Is delivery atldress tlillerent from item 1? ^ Yes ~ ~ q <br />IF YES, enter tlelivery address below: ^ No ~~,, ~ ~ Y~ <br />102a9S99M-1]B9 'ostayeB Feee ~~ <br />3. Service Type ~ ~ <br />~CertifedM I Epree~ail ~ ldivary Fee <br />^ Registeretl urn Receip f erchandise <br />^Insured Mail .O.D. dDelrvsryF <br />4. Restricted Delivery FatralF~o~ ~ ^ Yes eceipl Slaw <br />A. Receivetl by (Please Pnnt Clearly) B. Date of Del <br />~i~3- <br />C. Sgnature <br />X ^ Agent <br />h~ 1/i.vf~r/b. (~li~.M~..ri ^ Adtlre <br />D. Is delivery addrt~s tldterent from item 1? ^ Ves <br />If YES, enter delivery atldress below: ^ No <br />~' S <br />ivery i9 137 272 / <br />91 vice - _ -. ^V/ <br />or Certified Mail <br />Coverage Provided. <br /> <br />~~ <br />s <br />3. yS,erv~ice Type <br />u r.eriifietl Mail ^ Express Mail <br />^ Registered ^ Return Receipt for Merchandise Fee <br />^ Insured Mail ^ C.O.D. <br />4. Restricted Delivery? (Ext2 Feel ^ Yes ry Fee <br />Domesta Return Receipt <br />102595-99 M-1]B9 <br />i6 Fees S <br />P ad Leta <br />0 <br />LL <br />a <br />