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^ Complete items 1, 2, and 3. Also complete <br />item 4 if Restricted Delivery is desired. .i0 <br />^ Print your name and address on the re _l~- <br />so that we can return the card to you [~Qi" e <br />^ Attach this card to the back of the ilpiece,Qf <br />or on the front if space permits. 2 <br />1. Article Addressed to: / /201 <br />' !%/ qn~ ~fi/Gig /~t) yo <br />/qyc Y'Prnn/~n <br />A. Sign ure <br />_ ent <br />^ Addressee <br />ived by (Print d~fame) C. Date of Delivery <br />Is delivery address different from item 17 ^ Yes <br />If Y S, enter delivery address below: ^ No <br />3. Serv' Type <br />~ifietl Mail ^ cpress Mail <br />^ Registeretl ~ tdise <br />^ Insured Mail ^ C.O.D. <br />4. Restricted Delivery? (Extra Fee) ^ Yes <br />2. Article Number O~, <br />(transfer from service IabelJ ~7o9R 3 y00 7 ~ 522 <br />~ PS Forth 3811, August 2001 Domestic Return Receipt to25ss-or-M-25os <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 Adtlressetl t//o: ~ /~ <br />/o~• /~.G rl`/o IG.U*//D~ <br />`jpl IOr\r <br />Z75v /~ 2 o~J .._. <br />A. Signature <br />X ~ ~ ~ ^ Agent <br />^ Addressee <br />B. Received by (Pr.nninted Na ) C. Date of Delivery <br />D. Is delivery address different room item 17 ^ Yes <br />If YES, enter delivery adtlress below: ^ No <br />_ /~ . ~i~~6y~ <br />o r' ~ ~ ryyry <br />A~ Qom' '~j Service Type <br />B'~ <br />ifi <br />d M <br />il <br />re <br />Mail <br />^ <br />E <br />~ ert <br />e <br />a <br />) ss <br />mp <br />it <br />~ ~ ^ Registered ~ <br />ll Re[urn Receipt for Merchandise <br /> \ j ^ Insured Mail ^ C.O.D, <br /> \._.l-_ <br />1 rCO`~ ~ <br />4. Restricted Delivery? (Extre Fee) ^ Yes <br />, 2. Article Number ~/ /~ p ~j /~ f~ per q <br />~ (Transfer from service label) !~`7 -/ ~7~0 l/~~ 1 0 /~ g J~2~ <br />PS Form 3811, August 2001 Domestic Retum Receipt 102595-Ot-M-2509' <br /> <br />