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r. <br />v SENDER: <br />'y • Complete Hems 1 antl/or 2 for atlditiona Services. <br /> <br />I aISO Wlah t0 reeeiVe the <br />y Complete items 3, antl 4a d b. fplOWing eerVlCes (for an 8xtrd tyl <br />• Print Yaur name and address on the reverse of this loan so that we can foal: •~ <br />y return this cartl to Yoo. <br />• Attach Nis form to the Iront of Ne mailpiece, or on the back d space <br />1. ^ Addressee•S Add BSS <br />y <br />does nqt permit. <br />y • Wnte"Retum RecerptRequest¢d'"onthemail iece C¢IOW theaniGenumber. <br />p <br /> <br />2. ^ Restricted Delivery <br />6' <br />•y <br />• The Return R¢ceipt will show to whom the article was tleliveretl antl the date <br />c tlelwered. <br />Consul[ postmaster far fee. <br />y <br />v 3. Ar <br />ticl <br />A <br />d <br />dressed <br />to <br />: <br />e 4a. Article Number ~ <br />/ <br />F{/~~ <br />- <br />i <br />- <br />K <br />O <br />~ <br />~ <br />f m ' ` f <br />` r <br />n <br />" <br />" "` <br />~ <br />J <br />' • <br />/ <br />} <br />n <br />• „ /Q ~ ~ U ( O ~t L <br />/T 4b. Service Type <br />^ Registered ^ Insured Q <br />~ <br /> <br />w ~~ /~ <br />l.~U~~ / ~~~1~~ ^ Certified ^ COD <br />^ Return Receipt for <br />^ <br />~ <br /> ! Express Mail <br /> c <br />/1 Merchandise <br />G -~~,,, <br />~ <br />~ ~/L ~/ <br />~~ ~~ ~() 7. Date of Delivery w <br /> 0 <br />5. <br />6. Signature (Agent) <br />a <br />6. Addressee's Address (Only if requested Y <br />and fee is paid) ~ <br />t <br />r <br />~ ~'_/ <br />N PS Form 3811, December 1991 au.s.ePO:reiz~2aJOti DOMESTIC RETURN RECEIPT <br />