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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 />I ^ Attach this card to the backof the mailpiece, <br />or on the front if space permits. <br />-1. Article Addressed to: <br />g01~ ~V4n 11~t~1 __. <br />'For~a• <br />vS ~'o~a5'~ Serve t <br />ItS 81-Yt1~~ C011r'~ <br />y „~~~ ^ Agent <br />^ ~ ^ Addressee <br />B.~ec~lvetltby (Printed Nafne) C. Da~e of Delivery <br />Is delivery address different from Rem 17 ~~ Yes <br />If YES, enter delivary.atldress below: ^ No <br />3. Service Type' <br />~rtified Mail ^ Express Mail <br />^ Registered i~etum Receipt for Merchandise <br />^ Insured Mail ^ C.O.D. <br />4. Restricted Delivery? (EMra Fee) ^ Yes <br />2. Article Number V' ~ / <br />(Trans/er from service labe9 7 a o 3 I t)1 ~ Q (~(~ ~ 1 ~ b ~ ~~ <br />~PS Form 3$11, August 2001 ~ Domestic Return Receipt 102595-o2-M-lsao <br />rt7 ~ ~ <br />~ •. • ' ~ <br />O ) ra ~ ~ <br />i a ~ u~ ~ ~ .~~ ~ ~,a ~ ~ ~ o .. .. ~ <br />M1 iE~ <br />~ Ponfage S i ~ ~ rR ,~ <br />0 CeNRed Fee /~ O } e $ <br />.-~~ Postag <br />0 Retum Recl~ePt ~ ~ ~ . ~ ~ ru certmed Fee ~ <br />(FsdaraemeM ul U ~ O ~ <br />O ResMctatl DeGVery Fee ~ oo O Rehm Redept Fee ~ ~ <br />~ (Endorsement Required) Cl Qr'~ 17 (EMOrsement Required) ~ <br />~ Total Postage 8 Fees V5 O Restrkied Delivery Fee l <br />4. _ OZ/2$f06 ,~ (Endorsement Required) CZ <br />O <br />mo sem ro a ?Dial Passage a Fees $ 4.64 .:.: 021; <br />..S~f~a_n_~uan__~1.~.~.i-a-ra..l---For~~~--_._------ r*t <br />M1 a`r/eet ~ /Y!!.~ aril TO r . <br />wromrnra--~~..FeY4.§~._Sir_t7\rt...1.~..Batrn:e:H_SA!?r~ o Qfc.~tg!~---~---~y~.°-PERK{, <br />CHy, Sret&7JW4 <br />[` $Yiea4 fir. XIG.: QQ ^1 <br />T Co ~ ~3d or PD BozNO..-~5~~...-"':....(,~>~-Wi.. ~. <br />$u}A)Dt V I B~Sf/ <br />_ :,, „ <br />I <br />. . <br />^ Complete items 1, 2, and 3. Also complete A. Signatur ~ ~ <br />Rem 4 if Restricted Delivery is desired. <br />^ Print your name andaddress on the reverse <br />so that we Can return the card to you. R. Received by (Printed Name) ~ C <br />~' ^ Attach this card to the back of the mailpiece, <br />or on the front if space permits. <br />1. Article Addressed to: <br />PcGi{AR~ ~ EVE PERK~1~ <br />1e4 Ne looWe~~~-y <br />B~.Au~l~-, uT <br />ays~~ <br />(`1 <br />4f1~. N W <br />Agent <br />^ Addressee <br />D. Is delivery address dtrfereM from Rem 17 u Ye: <br />If YES, enter delivery address below: ~ ~ No <br />3. Service Type <br />®'{.ertifed Mail ^ Express Mail <br />^ Registered fiYFtturn Receipt for Merchandise <br />^ Insured Mail ^ C.O.D. <br />4. Restdcted Delivery? (Fxha Fee) ^ Yes <br />2: Article Number .-7 Ate, ~ ~O L }Y ~ ©.L ©-~ ~ /_ [~ 23 <br />(Tmns/er fmm seMce /abed c.JC.) lJ tJ l <br />PS Form 3811, August 2001 Domestic Return Receipt ~ 102595-oz-M-l Sao <br />