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v SENDER: <br />v .Complete items 1 enNOr 2 br additional services. <br />m .Complete items 3, da, and db. <br />m • Print your name and address on Ne averse of this form so that we wn return This <br />rartl to you. <br />~ •Aaech This loan to the hoM of the malpiece, or on the back it space does nm <br />m pemtit. <br />y •Wdte'Re(um Reaerpr RequE <br />~t„ .The Relum Receipt will shm <br />C delivered. <br />O <br />v <br />3. Artcle Addressed to: <br />' // <br />ds ~d5 <br />S <br />E ~- <br /> Zap 'CQS't <br />N <br />N <br />~ 1 / r vt.~ c~ x>< . <br />0 <br /> <br /> 5. Received By: (Print N <br />F <br />w <br /> <br />~ 6. Sign furs: (Addresse <br />;, ~( G'1 <br />. m PS Form 3811, Decem <br />the mailpiece below the anicle number. <br />n the snide was delivered and the tlate <br />~~ I ~t1111(.135. <br />~ 5t ~. <br />e~ g(c~a <br />r <br />r <br />7994 <br />I also wish to receive the <br />following services (for an <br />extra tee): o <br />1. ^ Addressee's Address •`-' <br />Z <br />2. ^ Restdcted Delivery y <br />Consult posenaster for tee. ~ <br />a <br /> • <br />r~31 395 <br /> <br />rpe ° <br />Y <br />^ Registered ^ Certified <br />m <br />^ F,cpress Mail ^ Insured 5 <br />a <br />^ Return Receipt for Merchandise ^ COD <br />7. Date of Delive <br />~.:.~0 9~ <br />T <br />6. Addressee's Address (Only it requested ~ <br />and /ee is paid) i <br />I- <br />P 6 431 395 <br />o rvice <br />' t for Certified Mail ~ <br />N once Coverage Provided. ~' <br /> <br />u <br />`s <br />C <br />d <br />r <br />i <br />li <br />u <br />0 <br />of use for Intemafional Mail See reverse <br />~5 771 <br />r{'fa ~rm <br />u <br />~{9~ <br />[ <br />ixJ~u`r`70` ~~ // <br />SC. <br />ce, Su 8 ZI tJ <br />1 1~.C ~ ~ ~/,~ qn_ <br />[X1o <br />Poshpe <br />Cer7fied Fee _ ~ ~ w <br />Spedal Delivery > ~ C^ ~\ <br />RastdLied Deft ~ ;.~ <br />i ~ t <br />~ Rehm Receipt to <br />WtgmBDale <br />~ <br />N~ <br />F ReCSn Reroq ~ 6VVllanl, <br />• Daro, 8 Mdessee's 4.j ~.^. <br />TOTAL Postage 8 Fees ~, <br />I t= -~' <br />I Pastrnerk or Doh , ' <br />f <br />I <br />..r.. <br />w <br />.L <br />w <br />(D <br />Iv <br />v <br />m <br />CD <br />n <br />O <br />N <br />0 <br />