Laserfiche WebLink
^ Complete items 7, 2, and 3. AISO,GOmplete <br />item 4 if Restricted Delivery.is desired. <br />^ Print your name and address ortthe reverse <br />' so that we.can return the~card S4 You. <br />^ Attach this card to the back.of the mailpiece, <br />or on the front it space permits. <br />1. Article Addressed to: <br />~~sd~erc~y <br />~ ~~ <br />L15D 33~ Strie4, Sk '20i <br />!moo-,.,.Idle C~ s a3o~ ~sr <br />A. Sig ur <br />X ^ Agent <br />vim' U ^ Addressee <br />B. Received by (Punted Name) ~ C. Date of Delivery <br />D. lsaelivery address different from item 17 ^ Yes <br />If YES, enter delivery address below: ^ No <br />3. Service Type <br />.~Certifed Mail ^ Express Mail <br />^ Registered ^ Return Receipt for Merchantlise <br />^ Insured Mail ^ C.O.D. <br />4. Restnctetl Delivery? (Extra Feel ^ yes <br />z. Article Number 7001 1140 0002 3883 7128 I <br />(Transler from service label) r <br />PS Form 3811 ,August 2001 Domestic Return Receipt 102595-01-M-2509 <br />,- ;. <br />~ <br /> <br />M1 <br />I ~a g~ t <br />~ ~ F°d Il= gg gg ~~++ <br />..&J' w~T <br /> <br /> <br />m Poate9a s . ,3 ~ <br />~ <br />m . <br />m CertlFled Fee n <br />Q(' ~ ~ tr~AG~, <br />fL Retum Reoelpt Fee / ~ ~ ~ ~ ~P He .m~~ <br /> <br />(Endorsomant Raqulratl) , <br />_ <br />~ , <br />ti <br />~! <br />'~ <br />~ <br />O ResNCted Delivery Fee <br />(Entlarsement Requiree) a' <br /> O <br />~ <br />' ~ Total Poete9e 8 Fees ~ 3 . ~ ~~~ <br />S />.~ <br />~, rl a TO r -.... <br />~ouk~'-G'1~rk--e------x~rde.-~------- <br />,~ <br />° Street, APt. Na.;~~~ ~ ~ /7~ / r ' <br />-- ~? ------------------- -~----- ti,l 0-201 <br />-'' <br />- <br />~- --- -- --- -- <br />- <br />- <br />~ ~5 a <br />y <br />city si,aie, zrd~ ~ <br />q <br />" <br />~ <br />