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•$ENDE R: Complete items 1 end Z when edtlltlonel services ere tleslretl, and complete items 3 <br />and 4. <br />Put your etldreo in the " URN TO" Space on the reverse side. Failure to tlo' viii prevent this <br />certl from being returnad\/you. Sha return recelot }ae will orovltle you iho .1b of the oerson <br />delivered to end the tlete of delivery. For etltlltlonel fees the following services are available. Consult <br />postmaster for Tees end check box (as) for additional servlce(a) requested. <br />t. O Show to whom delivered, data, and addressee's address. 2. ^ Restricted Delivery <br />1 (Extra chargeJt t /Extra charge) t <br />Add <br />3. Article <br />re <br />sse <br />d <br />to <br />: <br />. 4. Article Number <br />/~ <br />~ <br />(~ <br />P <br />• ~ ~ a7 <br />rv <br />~ ~ ~ <br />~ <br />~ <br />~ <br />~ <br />~ <br />(~f~ll2/IfIO LQ ~-0~ L>1-1/l. l ~ <br />Type of Se <br />1 ~ <br />+ ^ Registered ^ Insured <br />~1Certified ^ COD <br />P r ^ Exp2ss Mail <br />~ ~/ ~ ~' ~ ~ <br />6-~( Always obtain signature of addressee <br /> or agent and DATE DELIVERED. <br />5. Signature -Addressee <br />X 8. Addressee's Address (ONLY i/ <br />requ~led arfd fee paid) <br />6. Si to -Agent <br />t ! <br />e <br />7, D e oT Delivery <br />PS Form 3871, Maz. ]9B7 <br />• U.S.C.P.O. tee?-t 79-766 DOMESTIC RETURN RECEIPT <br /> <br />N <br />O <br />Or <br />d <br />0 <br />n <br />E <br />IL <br />N <br />a <br />RF 2~6 m-B'~-o`~3 <br />P 765 476 276 <br />RECEIPT FOR CERTIFIED MAIL ~ ~-' <br />NO iNSIIRANCE COVEMGE 1'a0V10E0 ~,~ <br />NOl FOa INTEeNATIONAL MAIL <br />(See Reverse) -A <br />Cx1 <br /> <br />Sect w <br />Slr tan No ~~ <br />P .Slat and ZIP Code <br />Postage S <br />I,, '! <br />Special Delwery Fee 1900 <br />Restricted Delivery Fee 00 <br />g3~~cc ~~pp~~. Ir- gg--,~ <br />bel~e~+,slpedtl)aEAaef~ Q~ ES~~N <br />Return Receipt showing to w <br />Dale. and Address of Derry <br />TOTAL Postage and F Gs~, ~ 5 ~ , <br />Postmark or Dale ~ ' <br />i <br />.s <br />C:3 <br />(•l <br />-r <br />is <br />s, <br />ppJ~~ <br />T' <br />GS <br />Cv <br />i <br />O <br />fV <br />W <br />