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�: 5 t S�Ci� tZ� <br /> � • . . . . , <br /> ■ Cc�mple4e items 1,2, and 3..41so complete A. Signature <br /> item 4 if Restricted Delivery is desired. ❑Agent <br /> ■ Print your name and address on the reverse X i _��.�n,t�.-�l'i�.1�;,,, ddressee <br /> so that we can return the card to you. B. Received by(Pdnted Name) C. D�of livery <br /> ■ Attach this card to the back of the mailpiece, �' <br /> or on the front if space permits. `�. 'I,� � <br /> D. Is delivery address different from ftem 11 ❑Yes <br /> 1. Article Addressed to: if YES,enter delivery address below: ❑No <br /> M►�c�e1 �. �ri1 n <br /> � <br /> ��'"K' �`',_ 3. rvice Type _ <br /> ��G� �',�t`��/VA/� �' �rtifledMail ❑ExpressMail , <br /> .J � V��V��� �� � ❑Registered ❑Retum Receipt for Merchandtse <br /> ❑ Insured Mail ❑C.O.D. <br /> '•`�^��Al••i l ( 'v �t� '�U 4. Restrlcted Deliveryl(ExtraFee) ❑Yes <br /> 2. Article Number <br /> (rranster�rom se►v�ce►abeq 7��7 2 6 8� ��0 2 3 4 5 7 2119 <br /> PS Form 3811,February 2004 Domestic Retum Recelpt ���Z�.�� <br /> . � <br /> ' � . . . <br /> � '' • - <br /> n� - <br /> rti <br /> �n � `BAy <br /> � Postage $ � P. <br /> � Certified Fee ���}� � �� <br /> o�� V � <br /> � Return Receipt Fee ��3a JUIV���� w <br /> p !EndorsemeM Required) <br /> � Restricted Delivery Fee <br /> O (Endorsement Required) <br /> � � 5 5 �'SPs�.-". <br /> � �'���!Rostage&Fees <br /> f1J <br /> -- <br /> o M� � -. . <br /> _ �_------�r�,lyn�t�l�h--_v�p��_---------- <br /> � �t�A�71_s_�+�Ik�h__Dr--------------------------- <br /> ----------- <br /> �e���wn nt 3g�3g <br /> �� ��� �� <br /> . ,`F dw����«, ' <br />