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♦' <br /> a; SENDER: <br /> • Complete items 1 and/or 2 f <br /> rn • Complete items 1 for additional services. <br /> m and 4a&b. I also wish to receive <br /> in • Print your name and address on the reverse of this form so that we can the <br /> y return this card to you. following services (for an extra a; <br /> • Attach this form to the front of the mailpiece, or on the back if space fee): V <br /> does not permit. .i <br /> a� • Write"Return Receipt Requested"on the mailpiece below the article number. , Addressee's Address ct <br /> t <br /> •-' • The Return Receipt will show to whom the article was delivered and the date <br /> c delivered. <br /> 2. ❑ Restricted Delivery a <br /> -13 3. Article Addressed to: Consult postmaster for fee. <br /> n - 4a. Article Numb °� <br /> d C.�..l.,c..r, oC <br /> E <br /> l� l3 9 si oE <br /> /1�(7 O � Q �� ��, 4b. Service Type <br /> w /LG(� /X�"J Li) Registered ❑ Insured <br /> � �G�' �, N 5 Certifi-d ❑ COD °) <br /> 0 W 0 ' `J 3`� / ❑ Ex res. <br /> Pitii� ❑ Return Receipt for <br /> 3.5 <br /> Q 7. Date of IeliveAWP <br /> ry Merchandise <br /> CC 5 a ure (Ad• sseo <br /> c <br /> 8. Addressee's Address (Only if requested Y <br /> Ml 6. Signature (Agent) and fee is paid) <br /> c <br /> I— <br /> o <br /> o cot <br /> H "S Form 3811, 0 ecember 1991 • U.S.G.P.O.:1992-307-530 DOMESTIC RETURN RECEIPT <br /> P 137 892 810 <br /> ivReceipt for <br /> - Certified Mail <br /> i 41No Insurance Coverage Provided <br /> oos,',PsEZF Do not use for International Mail <br /> (See Reverse) <br /> Sent to <br /> o�, ',r 5 , . <br /> 'treean1ti,r -- .. <br /> e 4 <br /> '1-'p;tatty and-IP —�/, Al <br /> ' Code <br /> 9 I1 l .,1E: 3 ''i <br /> east,, e i <br /> $ , , q <br /> IIIIIIIIMIIIIIIIWISM <br /> Special Delivery Fee <br /> Restricted Delivery Fee <br /> IIIIIIIIII <br /> Return Receipt Showing <br /> 01 to Whom&Date Delivered <br /> o Return Receipt Showing <br /> C Date,and Ad. to Whom, <br /> � �P�'y' ess <br /> TOTAL P ltd ,� <br /> � &Fees ,`��+ <br /> CO <br /> CI <br /> ZIO <br /> L lqM <br /> u) <br />