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^ Complete items 1, 2, and 3. Afso complete <br />' item 4 if Restricted Delivery is desired. <br />^ Print your name and address on the reverse <br />so that we can return the card to you. <br />^ Attach this card to the back of the mailpiece, <br />or on the front if space permits. <br />t. Article Addressed to: <br />l ~t,~~u: vr.r ~s ~ ~- <br />~,~~. E-le J~ <br />~o l~~ ~~ ~ <br />6oldEn, GO ~`~1 <br />A. <br />(Printed Name) I~C. D'a4e of <br />D. is delivery address diHerentfmmitem l4 ^Yes <br />if YES, enterdelivery address below: ~No <br />3. Service Type <br />~Certifietl Mail ^ Fxpress Mail <br />^ Registered ^ Return Receipt for Merchandise <br />^ Insured Mail ^ C.O.D. <br />4. Restricted Delivery? (Extre Fee) ^ yes <br />2. Article Number <br />(7rens/er /rom service label) 7QO:L ,~ s~ X00 1 7U'~j l]!j~ <br />PS Fonn $811, August 2001 Domesbc Return Receipt 2ACPRI-03P-00a1 <br />^ Complete items 1, 2, and 3. Also complete <br />item 4 if Restricted Delivery is desired. <br />^ Print your name and address on the reverse <br />so that we can return the card to you. <br />^ Attach this card to the back of the mailpiece, <br />or on the front if space permits. <br />1. Article Addressed to: <br />~%l~ ~~.Ci~ . <br />grr,v : ~PrSrwwnen:f5 <br />SgC I Sk~~ ~~~~ <br />~~fc~d~, Go <br />~coo3 <br />^ Agent <br />B. Received by (Printed Name) 1 C. Date of Delivery <br />D. Is delivery address different rRtte.:~T-~T-°Yes., <br />ti <br />it YES, enterdeliveryadd ss~~w: •'L] N6? ' <br />. v„~i~ ~_ <br />~~. ~. <br />3. Service Type ` <br />~Cerdfietl Mail ^ Express Mail <br />^ Registered ^ Return Receipt for Merchandise <br />^ Insured Mail ^ G.O.D. <br />4. Restricted Delivery? (Fxba Fee) ^ yes <br />2. Article Number / ~~[ _ <br />(T2nsler/rom service label) "~p(..~ ,~.+,5~ (J['iQ I 7[o`I~"rl ~~,~ <br />PS Form 3811, August 2001 Domestic Return Receipt zACPRI~oaP<oet <br />.~ ~ - r <br />~ ~. <br />r <br />` ,. <br />M1 Pestage 9 <br />~ CONged Fee <br />O <br />~ Return Reciepl Fee y ~~ P Rosunark <br />(Endorsement Required) <br />~ Restrkled Delivery Fee <br />u"I (Endorsement Requred) <br />r3 d. ,I ~/~ <br />fTl Total Postage 8 Fees y ^Y'. `J',~ <br />rU <br />p ro . <br />o s . ~-}kc o5t ' 1~(zaf' <br />ar PO Bµx Na ~7i~($1----i2i_r~.1.-----Du,~~ <br />Ci'ry, §faie, ~~Pr4- -~ <br />~Idr-~~ ~~ `mi'l <br />ru i <br /> <br />rn ~• <br />r <br /> ; ~ pp <br /> <br />.a <br />r`' Postage s <br />~ Cgnlfre0 Fee <br />~ , 3 <br /> <br />~ Postmark <br /> <br /> <br />~ <br />ReNm Raclepl Fee _ <br /> <br />~ <br />Hare <br /> (FaWOrsemant Required) ~, <br />~ <br />O Restricted Delivery Fee <br />trt IEndoroement Requuad) <br />ra <br />frl Total Postage 8 Fees ~ ~/ <br />fL <br />f~ Sheet, Apt.No.% C_lO. _.._~__... ~Jl. ~_ <br />orPO Box No. J <br />clry were, PIPH <br />~'rzttQ~i~i ~ ~UOG3 <br />