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m SENDER: <br />'~ • Campleto items 1 antl/or Z for atld~OOnY. ccrv¢ca. <br />s1 • Complete items 3. end 4e & b. <br />H Print your name end address on the reverse of this form eo [het we can <br />m return ihrs card to You. <br />m • Attach this form to the irant of the mailpieca, or on the beck if space <br />does not permit. <br />o • Writo"Return Receipt Reeuested"'on the mail0~ece below the article number <br />w • The Return Receipt will show [o whom the enmle was delivered and the date <br />C delivered. <br />9 3. Article Addressetl to: 4a. Art <br />E 1l~ ~t'~ IQLO , <br />4b. Sei <br />I also wish to recow~ :he <br />following services (for an e.ctra <br />feel: <br />1. I] Addressee's Address <br />2. ^ Restricted Delivery <br />insult postmaster for fee.' <br />Number <br />N ~ L.C ~~l` ~ / I `~ ~v '~v ®Certified d <br />^ Express Mail <br />~ 7. Date of Deliver <br />.il~ <br />7I 5. Signature (Addressee) 8. Addressee's Ad <br />f„ and fee is paid) <br />W <br />0 6. S~gn~tyre (Agentj' _ <br />> r <br />^ Insured <br />^ COD <br />[] Return Receipt for <br />V <br />.~ <br />O <br />N <br />6 <br />.0 <br />V <br />c <br />_o <br />Q <br />a <br />c <br />.' <br />- o <br />0 <br />~s <br />m <br />~f <br />= PS Form 3811, December 1991 - us.GPO_t99z3m~53n DOMESTIC RETURN RECEIPT <br />F <br />