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~ Z 191 ~~9~8, 6 4 5 _ <br />~t,S Postal Service rr,, ~~ ~~ qq ~~ <br />„~ Receipt for Ciertiti~il_Mail <br />GJ No Inwrsnce Coverage Provitled <br />W o not use for Intemadonel Mail See reverse <br />~ t <br />I <br />~ <br />N Slime l <br />\ <br />J <br /> 1- <br />N P <br />gfice, State, ZIP Cod <br />~ P~mpe S <br />N Certfied fee <br />.L <br />(l7 <br />Spend Deli+my Fes <br />f+~Dr Flssaitled Delivery Fee <br />~g Retum Recdpl ~ 8~ - <br />ls Wltwn80ua <br />` hOm Petapl m <br /> D~,8Atl6ev <br /> TOTAL Pods S! ss <br /> Possnerk or D 0 dye <br />Vl <br />a <br />r• <br />0 <br />a <br />a <br />0 <br />c <br />a <br />a <br />0 <br />v <br />•Complete items 1 ardor 2 for additiorW serncae. I also wish t0 leCe1VB thB <br />•Complete items 3, ba, and 4b. fOIIOWIng SBrVICes (}Or an <br />• Pdm your name erW address on the reverse of this farm so that we can return Vds extra fee <br />~ <br />wrd to you. ~ <br />• Attach this brrn to me from of the malpiece, or on the back it space does not 1. ^ Addressee's Address <br />Z <br />permit. <br />•Wdta'Aetum Receipt Requested'm the rneilpiece blow the snick number. 2. ^ RBStricted Delivery y <br />•The Relum Receipt will show to whom 1hB erode was delivered end the data « <br /> <br />delivered. <br />Consult postmaster for fee. Q <br />3~Article Adtlressetl lo: 4a. Article N mt <br />I 4D. SeMce Typl <br />~ `l .~ (~ ` ^ ~ , ^~,.., ~ <br />i`\J ~~~~~) I J ^ Registered <br />^ Express Mail <br />~ <br />~++ <br />~ ^ Return Receipt <br />~ <br />~'~~. 1 7. Date of Delive <br />and !ee is paid) <br />e. ~Xnatu/~ e o <br />0 <br />n <br />CcUS <br />`~ c y <br />~p Certifred ~ <br />/^ Insured 5 <br />n <br />a ^ COD ~ <br />o <br />>, <br />r!lrequested ~ <br />r <br />Ps Form 3811, December issa U Domestic Return Receipt <br />