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c <br /> P 5 2 L qAon 3 <br /> �p4Po er ce �_ <br /> ce" ertified Mail 4 <br /> N,gg I*u Coverage Profiled. (A, <br /> vinot use for International Mail See reverse(/-. <br /> Seni to <br /> Sir r <br /> ce,State, ZIP <br /> tag ` <br /> Ce ed Fee <br /> Special DLO Y <br /> Restricted Delivery Fee <br /> Return Receipt Showing to <br /> Whom&Date Delivered <br /> a Retum Receipt Showing to Whom, <br /> Q Date,&Addressee's Address <br /> O <br /> 0 TOTAL Postage&Fees <br /> CD <br /> Postmark or Date <br /> E <br /> of <br /> U)I <br /> CO- SENDER: <br /> a ■Complete items 1 and/or 2 for additional services. I also wish to receive the <br /> W ■Complete items 3,4a,and 4b. following services(for an <br /> d ■Print your name and address on the reverse of this form so that we can return this extra fee): <br /> card to you. <br /> > ■Attach this form to the front of the mailpiece,or on the back if space does not 1. ❑ Addressee's Address 2 <br /> d pe mit. Z <br /> w ■Wnte'Return Receipt Requested'on the marlpiece below the article number. 2. ❑ Restricted Delivery 4) <br /> ■The Return Receipt will show to whom the article was delivered and the date <br /> c delivered. Consult postmaster for fee. a <br /> m 3.Article Addressed to: 4a.Article Number d <br /> a l J I Q-OkOl , 4 14ss� . �, s�l0 3 c� � � <br /> E 4b.Service Type <br /> V d 0 �j p r as a c� ❑ Registered a Certified M <br /> r1 ❑ Express Mail ❑ Insured c <br /> t] <br /> G t�,r�i �—twin l56 <br /> Z ❑ Return Receipt for Merchandise ❑ COD <br /> ci <br /> Q 7.Date of Delivery ° <br /> oZC 0 <br /> 5.Received By: (Print Name) 8.Addressee's Address(Only if requested <br /> Q �/�/ �"`' � and fee is paid) t <br /> 6.Signature: (Addressee o A ent) <br /> �°• X <br /> PS Form 3811, December 1994 Domestic Return Receipt <br />