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lie Complete items 1, 2, and 3. Also complete <br />item 4 if Restricted Delivery is desired. <br />our name and address on the reverse <br />¦ Print A. Signature <br />X <br />? Agent I <br />? Addressee I <br />y <br />so that we can return the card to you. <br />¦ Attach this card to the back of the mailpiece, B. Received by (Printed Name) C. Date of Delivery <br />i <br />ts. <br />or on the front if space perm <br />Is delivery address different from item 1? <br />D <br />? Yes <br />1. Article Addressed to, . <br />If YES, enter delivery address below: ? No <br />P C ?'?y mm Iss? s <br />7 ?Lrm i,o of <br />I <br />rGC? ? 1 11C S ?? ," ' v.J <br />C <br />C 3. Service Type <br />ti <br />Q <br />J Certified Mail ? Express Mail <br />1 ? Registered E?Retum Receipt for Merchandise I <br /> ? Insured Mail ? C.O.D. <br /> 4. Restricted Delivery? (Extra Fee) ? yes <br />I <br />2. Article Number <br />(transfer from service label) WK, 1,3r CC D I <br />PS Form 3811, February 2004 Domestic Return Receipt 10595-02-M-1540 <br />N <br />M <br />rU <br />`D <br />/ IC <br />CI <br />Cl <br />C7 <br />?r m <br /> <br /> C <br /> C <br /> <br /> <br /> <br /> <br /> WMEOMM <br /> <br />rU <br />m ru <br />m <br /> <br />ru . <br /> <br />--_--- a o <br />postage $ <br /> Certified Fee postmark <br />p <br />C3 O <br />C3 Return Receipt Fee <br />(Endorsement Required) Here <br />.?- -- CI Restricted Delivery Fee <br />(Endorsement Required) <br />- ED <br />C7 <br />C] <br />m CI <br />m <br />Total Postage 8 Fees <br />-- <br />.?.---- Sent To j? <br /> <br />rrL <br /> <br />° <br />C3 <br />C3 <br />------ C3 <br />Street, Apt. No.; [ <br />? / <br />or PO Box No. <br />?Q <br /> <br />?- <br />O -1 <br />mA <br /> p <br />4 .' <br />............... <br />Ci Sta?, ZIP+ . <br />? <br />f <br /> :r? r.