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•Cpnplne items 1 endor 2 for edtlidonel services. <br />•COmpfne items 3, 4a, erM <b. <br />•Pnm your name and address on the ravane of this brtn so Nn we <br />card to you <br />•Mech this form to the horn n the meilpiew, or w the beds if ape <br />permit. <br />• Wdte'Retum Rewlpt Requested' on the mailpiaw bolow me adide <br />•The Ratum Recelpl will show to whom the aside was deliyeretl an <br />tlnivared. <br />\po ~ ~a~ <br />1`~ <br />~lNa~ <br />T X % Cam! <br />PS Fonn 3811. December 1994 <br />m <br />m <br />O <br />0 <br />[~7 <br />li <br />a <br /> I also wish to receive the <br /> following services (for en <br />wn return this extra fe0}: <br /> <br />tloee nor <br />1, ^ Addressee's Address 0 <br />~ <br />Z <br />number. 2. ^ RestdGed Delivery y <br />me erne <br />Consult postmaster for fee. ~ <br /> <br />Y <br />ArfiGe Number <br />13~ gD1 <br />~ w <br />5oa <br />4b. Service Type ~ <br />^ Registered ^ Cert(fied <br /> <br />^ Express Mail ^ Insured rn <br />~ <br />^ Return Receipt fa Merdtaniiise ^ COD <br />7. Date of Delivery <br />~ ~ ~ ~ T <br /> w <br />tl <br />8. Addressee's Address (Only it requesfod ~ <br />and !ee is paid) <br />502 E31 ~0~ ~ <br />S-'. <br />>p9cu <br />:fi®~ c fp iji4d Mail <br />~. i <br />Do not use fnr Inlnmaennnr ue:r rc.... .......~._r i_t. <br />nYO - -- _ - -- <br />its N <br />d r <br />~~ <br />Post pfiq, Stale, 8 ZIP Code n ^ 1 ~~ <br />Postage s <br /> 3 <br /> <br />Certified Fee N <br /> J <br />Spedal Delivery Fee ~ <br /> <br /> <br />Resbided ~~~ " <br />ryes ~~.. <br /> <br />~ Q <br />(~ <br /> ~ <br />Rnum vnng k` <br /> <br />d Date Delivered m <br />~i <br />ReW bNTOm, <br />Dare,A AdA ~ •~ ^ <br />ai <br /> <br />TO Postage 6 Fees , <br />C <br /> <br />, {~ <br />+ <br />Poslrn or e ~ <br />i v <br />G <br />y~ T <br />L~ <br />- <br />r <br />r <br />~~ i, CJ <br />