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U.S. Postal Service,,., <br />CERTIFIED MAIL,, RECEIPT <br />(Domestic Mail Only; No Insurance Coverage Prc <br />For delivery information visit our website at www.uso.m. <br />M T <br />Ir $0.46, <br />ED postage: $3.10 <br />r-9 Certified Fee . $2.55 <br />ED Return Receipt Fee: <br />O (Ei <br />o R $6.11 <br />(E,, Total postag <br />e & Fees: <br />Total Postage & Fees <br />rq $ <br />C3 <br />rq <br />Em Street, Apt No; - -- ------------ <br />r- or � JL44(JAY-�- - .1 <br />-ate, Z ------ <br />PS Form 3800, Aijyt;�l ?.()Or S�e Rev(�rse foi Instructions <br />■ Complete items 1, 2, and 3. Also complete A. Signature <br />item 4 if Restricted Delivery is desired. <br />■ Print your name and address on the reverse <br />so that we can return the cam LO YOU. B. ecelved <br />■ Attach this card to the back of the mailplece, <br />or on the front if space permits. <br />D. Is delivery address different from item I? ❑ Yes <br />If YES, enter delivery address below: ❑ No <br />2-,13 <br />C--(- L j <br />Y14 <br />iv, -b R M -S <br />❑ Agent <br />by (Printed Name C. Date of Delivery <br />1. Article Addressed to: <br />0s . -16 4 C- ioamO)l <br />r06.5 S' WoqYdfid 4r, -trl <br />la,4 Ox, <br />919963 <br />3. Service Type <br />❑ Certified 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 7010 1060 0001 0936 9539 <br />(Transfer from service label) <br />PS Form 3811, February 2004 Domestic Return Receipt 102595 -02 -M -1540 <br />4- c uJ <br />