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Po stal Service,� <br />m ' ECEIPT <br />0�" ( <br />rq <br />c c <br />`° Certified Fee: $0.44 <br />C3 Return Receipt Fee: $2.80 <br />2.30 <br />C3 a mark <br />Postage &Fees: <br />Total Posta '' are <br />Er Restricted Delivery Fee $ ``54 <br />M (Endorsement Required) ( <br />C3 <br />u'1 Total Postage & Fees $ <br />E3 �_ <br />O ` <br />Lloyd A. & Patricia <br />or 881 Edwards St. <br />Q1( St. Libory, IL 62282 --- ---- <br />PS Form 3800, June 2002 See Reverse for lnstrucfirm� <br />• 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: <br />A <br />Agent <br />B. Received by (Printed Name) C. Date of <br />rPl�/ a hv S'r/'✓ 1'� <br />D. Is delivery address d ferent from item 1? e: <br />If YES, enter delivery address below: ❑ No <br />Lloyd A. & Patricia Ann Sandheinrich <br />881 Edwards St. <br />St 4ibory, IL 62282 )n T <br />�itlfled Mail ❑ Express Mail <br />❑ Registered ❑ Return Receipt for Merchandise <br />13 Insured Mail ❑ C.O.D. <br />PC) Bof.3 <br />w. rtestricted Delivery? (Extra Fee) <br />2. Article Number 6 Yes <br />(transfer mm_serv/ce 7005 0390 0002 8281 9233 <br />PS Form 3811 February 2004 Domestic Return Receipt <br />102595-02 -M -1540 <br />