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~ Gomplete .items 1, 2, and 3. Also complete <br />item 4 if Restricted Delivery is desired. <br />® Print your name and address oh 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: <br />,~°~ ~ ~~ sr~ s~r <br />A. ,ig re <br />Agent <br />X ~,,~ 4t~ ^ Addressee <br />eceived b Printed N~ me C. Dace of Celivary <br />/" r <br />! i~~.V t ~C~Vb~t, ,.. ~ , ~ ~ - ~ <br />is delivery address dfferent from item 1? ^ Yes <br />f YES, enter delivery address below: ~ No <br />3. Service Type <br />-2~Certified Mail ^ Express Mail <br />^ Registered @~ Return Receipt for Merchandise <br />^ Insurad Mail ^ C.O.D. <br />4. Restricted Delivery? (Extra Fee} ^ Yes <br />2'' 7087 256II IIII~7II 7Q27 9897.......__-- <br />f _ <br />PS Farm 3$11, February 2004 ~ +'JOmestic:R~ttirrmReceipt to2sss-o~-M-taco <br />~ Complete Items 1, 2 and 3, Also compiete <br />item 4 if Restricted De}IVery Is desired. <br />m Frint your name and address .on the reverse <br />so that we can return the card to you, <br />® Attach this card to the Dock bf the mailpiece, <br />or on the front if space permits.. . <br />1. Article Addressed tc: , <br />~~~y <br />~~ <br />A. Signat~rFe// ~,/ ~,/ <br />X ;- ~~,~G'`~~ ^ Addressee <br />B. ReceivEd by (Printed Narn4~ C. Da~~ f._~ I~ery <br />,`ti'll ~ , !/ <br />D. s delivery address different from item 1'?I ^ fie` <br />if YES, enter delivery address below: ^ Ne <br />13. Service Type <br />t~"Certified Mail ^ Express Mail <br />^ Registered $-Return Receipt for Merchandise <br />^ Insured Mail ^ C.O.D. <br />4. Restricted Delivery? (Extra Feel ^ Yes <br />_ _.._.. <br />_..._._ <br />---.... <br />7IIII7 256II IIIIpp 7Q27 `~gII3 ____.: <br />,,. ,W.... _. _.._ <br />P;~ F~~rm 381:1,.~ehruarv2E3a4 Domestic ~ietvr _:xi~epc <br />~ Complete items 1, 2, and 3. Also compiete <br />item 4 if Restricted Delivery is desired. `` <br />'t~ s Print your name and address on the reverse <br />so that we can return the card to you. <br />® Attach t'nis card to the back of tt~~e maiipi?ce;, <br />or on the fron± if space permits. <br />i. ArticleAddressedto: ~~ /. <br />~ S3` 5!_~~.,~-arc-.- ~, <br />~~'~ ~~ ~~ <br />toz5ss-42-Nt-iSho <br />^ Agent <br />^ A.ddressee <br />by (Printed ) C. Date of Delivery <br />D. Is delivery address different from item 1? ~ Yes <br />If YES, enter delivery address below: ^ No <br />3. Service Type <br />L~"Certified Mail ^ 6cpress Mail <br />^ Registered ~ Return Receipt for Merchandise <br />^ Insured Mail ^ C.O.D. <br />4. Restricted Delivery? (Extra Fee) ^ Yes <br />70II7 2560 aon~ 71727 988II <br />;:PS.Form 3811, F2tjruary 2004 Domestic:Retum Receipt ;•,; fozss5-oz-M-tsao <br />