REV101219

• Permit No: M1981114
• IBM Index Class Name: Revision
• Doc Name: MAP
• Type & Sequence: CN1
• Media Type: D
• Archive: No

> PS Form 3811, December 997 RU.S.GPG:tYY3-35YJ11 DOMESTIC RETURN RECEIPT
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SENDER:
9 Complete items tend/or Z for additional •arvices.

I also wish to receive the
m • Complete hems 3, end be a b. tollOWing SerVICeS Ifor en extra ~
~ • Prin[ your name end adtlresc on the reverse of this form so tha t we can feel: •~
o return this card to you.
p • Attach this farm to the lront o/ the mailpiece, or on the beck if
space
1. ^ Addressee's Address
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does no[ permit.
Y • Write"Return Receipt Requested"on the mailpiece below the article number.

2. ^ Restricted Delivery
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• The Return Reeeipt will show to whom the article was delivered and the data
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~ 3. Article Addressed to: ~
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5. Signature IAddresseel 9. Addressee's Address (Only if requested s
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6. Signature 1 1
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~ SENDER:
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y Complete hems 1 antl/or 2 for •dtlition•I services.
m Complsta hems 3, end Ia 8 b.
~ • Print your name entl address on the reverse of this loan so that we can
~ return this card to you.
` • Attach this loan to the front of the mailpiece, or on the beck it space
does not permit.
to • Write"fletum Receipt Requactetl"on the mailpiec•below the article number
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• The Return Receipt will chow to whom the article was delivered end the date
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I also wish to receive the
following services Ifor en extra
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2. ^ Restricted Delivery •m
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m 3~. ~Al rticle Addressed to: ~,
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N FS Form 3811, December 7997 au.s.GPmtea~-aszau DOMESTIC,RETURN RECEIPT
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