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^ 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 Addressed to:> ~ ,.y <br /> <br />U~/Vn ~~~ <br />~~~~~ "L%r ~~~i...~ <br />Si e / <br />~ ~ <br />/ ~ <br />®Agent <br />'~I/ ~"("~ <br />"L~ ^ Addressee <br />B. Received by (Printed Name) C Da of gelivery <br />E ~C N/ PFl P,4 M~f/fl ~ - O / 7 D 7 <br />D. Is delivery address different frog} 11 ^ Yes <br />If YES, enter delivery address below: ^ No <br />ervice Type <br />3. <br />S <br />4 <br />~ <br />fd~ Certified Mail ^ Express Mail <br />^ Registered ^ Retum Receipt for Merchandise <br />^ Insured Maii ^ C.O.D. <br />4. Restricted Delivery? (Extra Fee) ^ Yes <br />2. ArticleNumbet 7004 1,35 0~~4 326 93$9 <br />(transfer from service label) <br />PS Form 3811, February 2004 Domestic Retum Receipt to25s5-o2-M-tsao <br />~"~ n <br />' via <br />5 <br />`t <br />k:,+ 4 ' <br />