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<br />'in · Complete items 1 end/or 2 for additional services. <br />CD . Complete items 3, and 4a & b. <br />E! . Print your name and address on the reverse of this form so that wa can <br />CD raturn this card to you. <br />! . Attach this form to the front of the mail piece, or on the back if space <br />does not permit, <br />11 · Write "Return Receipt Requested" on the mailpiece below the article number. <br />... . The Return Receipt will show to whom the article was delivered and the date <br />delivered. <br /> <br />3. Article Addressed to: <br /> <br /> <br />OCC-/ dedY ~h€Mi ccJ <br />alllJ " Jon Si1/cLe V"' -W /Je;Jt <br />PO. Bt;j( 8{g~ ,/ <br />)-}DI/..S I- iJi?/ 7x. '11 /)0 I -IJ 8 (p l() <br /> <br />c <br />o <br />~ <br />CD <br />t) <br />''is. <br />E <br />o <br />u <br />en <br />en <br />w <br />Ill: <br />C <br />C <br /><C <br />~ 5. Signature (Addressee) <br />::l <br />.... <br />~ 6. Sign~---, .------ <br />=' ~..............- .........-- .,...,.-- /~----- <br />o <br />> PS Form 3 11, December 1991 1tU.S. GPO: 11l~352-714 <br />.!!! <br /> <br />2. 0 Restricted Delivery <br />Consult ostmaster for fee. <br />4a. Article Number <br />'P 380 If If{; 0 s::s- <br />4b. Service Typi~ <br />o Registered 0 Insured <br />~Certified 0 COD <br />o Express Mail ~eturn Receipt for <br />Merchandise <br />7. Date of Delive~ <br /> <br />8. Addressee's Address (On y I <br />an9ye.is paid) <br /> <br />I also wish to receive tho <br />following services Ifor an extra 3 <br />fee): '~ <br />1. 0 Addressee's Address ~ <br /> <br />a <br />'CD <br />u <br />CD <br />Ill: <br />C <br />... <br />=' <br />~ <br />IX <br /> <br />e <br /> <br />- <br />c' <br />'iij <br />::s <br />.. <br />o <br />... <br /> <br />=' <br />e. <br />ested ,; <br />c <br /><<I <br />.r. <br />I- <br /> <br /> <br />DOMESTIC RETURN RECEIPT <br />