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� i � • • • � <br /> ■ Compiete«ems i,2,and 3.Also complete A. yS'Lqnature <br /> item 4 if Restricted Delivery is desired. Xi , T� ❑Agent <br /> ■ Print your name and address on the reverse c1 �.ti--�-�=I �'� ❑Addressee <br /> so that we can return the card to you. �g, Receiv by LPrI ted Name) C. Date of Delivery <br /> ■ Attach this card to the back of the mailpiece, t;�P�cf� ,���j �� ,j��>L� /�} <br /> or on the front if space permits. <br /> D. Is delivery address different irom Rem 11 ❑Yes <br /> 1. Article Addressed to: If YES,enter delivery address below: ❑No <br /> ��be�'-� Umbe,h���' <br /> 2� �unv��odyC � <br /> 3. rvice Type <br /> O�� �� tC�J _A� ifled Mail ❑Express Mail <br /> ����� Registered ❑Retum Receipt for Merchandise <br /> V�'� � ❑I�sured Mail ❑C.O.D. <br /> 4. Restricted Delive�/1(Extra Fee) ❑Y� <br /> 2. ArticleNumber 7pp7 268� ���2 3457 2�58 <br /> (rransfer 1rom servlce label) ______ <br /> ; PS Form 3811,February 2004 ,� Domestic Return Receipt io2sss-02-ne-�sao; <br /> . � <br /> . � � . . <br /> � ►. � <br /> � - - <br /> � ,�, <br /> . . . . . -. - . . <br /> rt_I � < . <br /> r� � <br /> �n /�/�� ; <br /> � Postage $ ��*T �P � S <br /> m � P "�i� <br /> CertifiedFee ��^� h' O �� <br /> fLJ �v V% P�st��N� � <br /> p Return Receipt Fee > p'� Here <br /> � (Endorsement Required) .30 (t � <br /> 1� <br /> � Restricted Deiivery Fee � � <br /> O (Endorsement Reqwred) SACj <br /> /� J ` <br /> � Total Postage&Fees � 5 5Gh <br /> � - --- 1 _..� <br /> - - —_.._...._-------------- —_.. -- <br /> a rSent� V1� � .�_�l.If_1��"� -----------••----------•-- <br /> � <br /> 0 2�D�U11N4 �'1� ----------------------- <br /> � <br /> �r�n� YnN Q 1 <br />