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<br />° 213,3 1 633 <br />~ i' Q ~ ~yf~63 .. <br />us 1 '( p <br />R ertified Mail - ~ <br />~ •Coverage Provided. <br />~OAOi for Inlmm~ens: u~:: io__ - _ <br />~ ~l ~3 <br />S <br />DNivery Fee <br />nesmaes 'Fg9 ' <br />~ .~. <br />~ Rattan fled~pJ9hoxing to <br />_ Whom'7lflat9~D.e;G,vereA' •. _ <br />Q ~mpe~IGSMa;.,m Nlius. ... .- <br />Postage 8 Fees <br /> <br />1LI ~ <br />a - <br />m SENDER: <br />~ •CiOr11pIBIa eeR181 drlNOr 2 fOr adtllllOr1a16erv10es. <br />' <br />I a150 WiSb (0 reCQIVO tfla <br />m •Carnplele .tams 3, Ie, end db. following sefVlCe9 (}Or an <br />m • Print your name and atltlress on the reverse of this loan so Ihat we can velum Ihis extra flae): <br /> <br />j rartl to you. <br />•Aaech ihls form to the from of the mmlpiece, or on the back it spars tloe9 not <br />t <br />1. ^ Atldress~9'S Address <br />' - ei <br />~ <br />y . <br />permi <br />• Wdte'Retum Receipt Requested' on the mailpiece below me snide number ~ <br />2. ^ Res[ficted DeIN9ry u <br />y <br />L •The Retum Receipt wnl show to whom the aniGe was tlelivered an <br />tleimered. tl the date <br />Consult postmaster for fe$;: <br />. <br />ii . <br />~ <br />v 3. Article Addres~s~ <br /> <br />J,wt ~ <br />UrC'C'S <br />"F 4 r6cle Number - ' ~ <br /> <br />~ 2 f 3 35 i (o ~~ m <br />la )~ <br />~~ t <br />. <br />E 4b. Service Type <br />v <br /> C ~~(L 4~3 ^ Registered ^ Certified ~ <br /> <br /> <br />W <br />~x7p/~'{/^/ ~/ <br />~" <br />~~~ ^ F~cpress Mail ^ Insured <br /> <br /> <br />^ Retum Receipt for Melchendise ^ COD <br />c <br />~ <br />y <br /> V <br />W ! <br />o aU{~ Cl- 7. Date of Delivery <br /> <br />2 {{11L <br />D~I~ ' ~ <br />T <br />7 5. Received By: (Pdnf Name) 8. Addressee's Addr6>)s (Only it requested ~ <br />W and !ee is paid) ~ 7 <br />~9 <br />! r <br />~ <br /> 6. Signature; (A dresse ant) v <br />T <br />b X <br />~ ~ ~ <=f~ <br />Ps Form 3811, DecerJi r f ssa - ••.: Dorgestic Return Receipt <br />