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o SENDER: <br />V •Complela hems 1 and/or 2 for additional services. I also wish to receive the <br />m •Compete items s, ~a, end ab. following services (tor an <br />m • Pnnl your name 8rld eddres6 on the reverse of thi6 form ao Ihel wa can velum this extra fee <br />card to you. ~ •i <br />~ •Adach This form to the hoot of the mailpieca, or an the back it space does not t . ^ Addressee"S Addf855 ~ <br />~ permit. ~ <br />y •Wdle'Fetum Hewipr Requesfed'on the mailpiece below the oracle number. 2. ^ Restdcted D¢livery y <br />$ •The Retum Receipt will show to vdwm the etticle was darivered and the date a <br />~ delivered. Consult postrnaster for fee. .~ <br />0 <br />v 3. Article Addressed to: 4a. ArUCIe Number w <br />d 5z/ 41~ 719a <br />E ~ /1~l ( G ~~ ~~ ~ yp <br />L 4b. Service T e <br />° ~ 0 ~ ~ / ~~ h ^ Registered ^ Certified <br />° ~GU~1 Cos I Cow <br />y ~ <br />(] ~(]~ ~~~ ^ ExpressMail ^ Insured ~ <br />'m <br />^ Retum Receipt for Merchantlise ^ COD <br />o <br />°a / 1 ~j <br />I'11~ 1'St~ CO `-'T ~ ~/ <br />S 7. Date of Delive ~~ <br /> U <br /> <br />~ 5. Received By: (Pon Name) <br />-"- 8. Addressee' es~ (O ly <br />L <br />~ <br />" eq sled ~ <br />n <br />w <br />x ~ - and /ee is aid <br />' <br />t`. <br />~ I <br />~ f.;i L'~ O a ~ <br />~ 6. Sign ure: (Addressee rAgenrJ C* <br />n: <br />. <br />C/j <br />m X ~,^ <br /> <br />PS Form 3811. December 1994 <br />Dom <br />n Receipt J <br />