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.SENDER: Complete items 1 end Z when additional wrvlces ere dalretl, antl complete Items 3 <br />end 4. <br />Put your etldreu in the "RETURN TO" Space on the reverse side. Failure to tlo this will OrNeht this <br />certl Trom being ratu rood to You. The return receipt tee will provide you the name o1 the Derson <br />dellvervd to antl the tleta of tlellverv. For edtlitlpnel fees the following services ere available. Consult <br />postmaster for fees antl check box(es) }or additional Nrvlcs(s) requgtatl. <br />t. ^ Show to whom delivered, data, end etldreYSS i sddrws. 1. ^ Restricted Delivery <br />f (Extra cMrge/1 1/Extra charge/1 <br />3, Article Addressed to: 4. Article Number <br /> ~5 3iZ <br /> <br />~~~ ~ Type of Service: <br /> ^ Registered ^ Insured <br />1 q <br />-)Ok ~~ / <br />P.17 t "B.Gettified ^ COD <br />- <br />~ ^ Express Mell <br />~~~ f <br />dd <br />Al <br />b <br />i <br />i <br />t <br />e <br />n <br />rU~O~ ure o <br />ways o <br />n s <br />reu <br />e <br />ta <br />e <br />e <br />B <br />6 or agent end DATE DELIVERED. <br />5. Signature -Addressee 8. Addressee i Address (ONLY if <br />x H requested and fee pgidJ <br />6. Sign tu~ ;. Agent ~ ~ <br />x .~C~L'..~-~~ <br />7. Data of Delivery <br />ld-ZS~~ <br />PS Form 3811. Mar. 1987 • U.S.G.P.D. 1ge7-1762aa DOMESTIC RETURN RECEIPT <br />