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4-012,010 --055 <br /> <br />cal,lx IA14e?? <br />a (Domestic , <br />0 <br />O <br />Postage: <br />Certified ... °... <br /> <br /> <br />ru <br />N Ret Fee: <br /> <br />rn Rene/pt <br /> <br />Fee <br /> <br />2 ? <br />sl <br /> <br />ru <br /> <br />pt p <br />al : $ <br />8 <br />• <br />?., .. 0 <br />v <br />O <br />E3 Return . __._ °Sta9e & <br />(Endorsement Requireo, p $2.3p <br />ees: <br /> <br />O Restricted Delivery Fee <br />(Endorsement Required) $$.71 <br />M <br />rU <br />M <br />Total Postage & Fees $ <br /> <br />E3 Sent To <br />11U <br /> <br />- - <br />--- <br />------- <br />!---- <br />-- --d <br /> <br />-- <br />0 ree <br />t, <br />pt. <br />or PO Box No. <br />-- <br />7 La'?r)?. i ILPY D 1 <br />-Oqv . CD <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 />5 -71 s i C., I <br /> <br />I <br />A <br />A Si gnat <br />' ? Agent <br />X ? Addressee <br />B eceived y ( nted e) C. Date of Delivery <br /><01A) r )a-/D <br />D. Is delivery address different from Rem 1? ? Yes <br />If YES, e g , 4 ., ? `?dies" <br />r every a?s below: <br />? No <br />!!° -1 <br />'UU , <br /> <br />3. Sere! ype <br />ertified Mail ? Express Mail <br />? Registered ? Return Receipt for Merchandise <br />? Insured Mail ? C.O.D. <br />4. Restricted Delivery? (Extra Fee) ? Yes <br />2. Article Number <br />(rransfer from service label) ?008 3230 0002 ?253 0091 <br />`PS Form 3811, February 2004 Domestic Return Receipt 102595-02-M-1540