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~~i~ll~ttii~r~~a«i <br />~ SENDER: <br />• CGmptete items 1 arMror 2 for adtlieonal services <br />N <br />C <br />l <br />it <br />3 I also wish to receive the <br />lollowin services for an <br />9 t <br />°y ( <br />omp <br />ete <br />ems <br />. 9a. antl 4b <br />~ Pdn1 your name antl atldres5 on the reverse of Ihis Iorm so t hat we can relum this extra tees: <br />4 <br />i Gard 10 yOII <br />• Anach Ihis Iorm to the front of the mailp'iece. or on the back i1 <br />space does not <br />1.O Addressee's Address V <br />m <br />° permit <br />a Wnte 'Relum Receipt Requesletl'on the mailpioce below the erode number <br />2. Q Restricted Delivery ~ <br />in <br />y • The ReWrn Rece~pl will show to whom the article was delnar <br />aelrvered ed aed Ne date <br />Consult postmaster for fee, <br />n <br />0 3. Article Addressed to: 4a. Anicle Number ° <br />m ~- yzg 07-4 eta} ~ <br /> <br />a 't(LEr~~o nYT ~~+'~~ 7v AR-D O~ 4b <br />S <br />T <br /> . <br />ervice <br />YPe 5 <br /> Ce T~`rn~'fi~0e~t-2S ,~,~ <br />^ Registered ~.X Certdied ~ <br /> ~r5 (~p~~fi AJ~ ^ Express Mail ^ Insured ~ <br /> CrJ p~iziZ <br />JC <br />~ <br />^ Return Receipt tar MOrchandise ^ COD <br />~ <br /> rr~o, <br />n , <br />1 7. Date of Delive o <br /> 0 <br /> 5. Received By: (Print Name) 6. Addressee's Address (Only if requested Y <br /> and iee is paid/ m <br /> <br />6. Signature: (Addressee or Agent) L <br />~' <br />3 <br />O <br />T <br />=' <br />PS Form 3811, December 1994 <br />102595~99~8-0129 Domestic Return Recgipt <br />Z 228 Q24 G14 <br />US Postal Service <br />Receipt for Certified Mail <br />No Insurance Coverage Provided,^ <br />rtizA Df for <br />J~ <br />~ ej~LyL <br />Certified Feo <br />Delivery Fee <br />Restricted DeGrery Fee <br />W Perum Flecaln SMwity <br />WMrn b Date De~r~ <br />~I ~l3\~ <br />LL <br />