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<br />,.... <br />~ SENDER: <br />'Cii . Complete items 1 andlor 2 for additional services, <br />CD . Complete items 3. and 4a & b. <br />f! . Print your name and address on the reverse of this form so that we can <br />CD return this card to you. <br />~ . Attach this form to the front of the mailpiece, or on the back if space <br />.. does not permit. <br />.! . 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 />"Cl 3. Article Addressed to: <br />CD <br />... <br />III <br />Q. <br />E <br />o <br />(.) <br />en <br />en <br />w <br />cc: <br />o <br />o <br /><C( <br />:2 <br />IX: <br />;j <br />l- <br />w <br />I:!: <br /> <br />I also wish to receive the <br />following services (for an extra <br />fee): <br /> <br />1. 0 Addressee's Address <br /> <br />o Insured <br />o COD <br />~n Receipt for <br />Merchandise <br />ate of Delivery <br /> <br />e <br /> <br />CD <br />(.) <br />"~ <br />CD <br />en <br />... <br />Q. <br />"w <br />(.) <br />CD <br />cc: <br />c:: <br />.. <br />:::I <br />... <br />Cl) <br />IX: <br /> <br />Cl <br />c:: <br />'Cii <br />:::I <br /> <br /> <br />2. 0 Restricted Delivery <br />Consult postmaster for fee. <br />4a. Article Number <br />p 3~6 7/'3 <br /> <br />037 <br /> <br />.. <br />o <br />.... <br /> <br />6. Signature (Agent) <br /> <br />.. <br />:::I <br />o <br />)>0 PS Form 3811, December 1991 "u.s. GPO: 199~2-714 DOMESTIC RETURN RECEIPT <br />:!1 <br />