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;; SENDER: <br />•Complefe items lanU/or 2lor atlWhonal services. <br />.N •Complefe items 3, 4a, and Jb. <br />~ • Pnnl your name and address on the reverse 01 this form so that we can rewrn this <br />Cartl to you <br />~ a Anach This form t0 the front of the mailpiece. Or on the back it spate does nOl <br />d perrnn. <br />~ • Write Weturn Receipt Requesred'on the mailp~ece below the article number. <br />L • The Return Receipt will show to whom the article was delivered and the dale <br />delivered. <br />0 3. Article Addressed to: . A Icle <br />01 ~ (~,~y~~~ (1~ -(~ ~ 4b. Se~~ <br />~ ^ Xpres <br />^ u~ r~ ^ ReturnF <br />w~.c I 7. to otl <br />5. Received By: (Print Name) 8. Address <br />I also wish to receive the <br />fOIIOWIng SBNIC2S (tOr an <br />eXtra fee): <br />1. ^ Addressee's Address <br />2. ^ Restricted Delivery <br />Consult postmaster for fee. <br />tuber <br />n~~ DS3 <br />~Certilied <br />ail ^ Insured <br />~.Ipt for Merth~.ntllse ^ COD <br />livery•~ •.; <br />-~ ~f <br />and fee is paid) <br />w <br />6. Siygna : (Addres gent <br />y ~ X <br />T <br />PS Form $11, 4 lozsss-ea~e-ezze DOR <br />d <br />N <br /> <br />m <br />Q <br />rn <br />c <br />N <br />0 <br />0 <br />T <br />Y <br />C <br />n <br />r <br />f- <br />