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• SECTION <br /> ON <br /> [� • ' Agent <br /> r� Addressee <br /> rti1 _ (Printed ame) C. Date of Delivery <br /> MI 1 �.I, 1� <br /> -0 Postage <br /> riJ 9 � dress different from item 1? Yes <br /> Certified Fee n t' <br /> delivery address below: El No <br /> Postmark tf� <br /> ru <br /> CD Return Receipt Fee Here <br /> r-1 (Endorsement Required) <br /> C3 Restricted Delivery Fee J <br /> (Endorsement Required) <br /> rij <br /> s <br /> ro Total Postage&Fees $ C <br /> � ru 1 rl Express Mai <br /> Er Sento �/ r - � - + /� •MM� l /� la O(Return Receipt for Merchandise <br /> �� I J! /.Y .1.:.--•-1«_• ❑ C.O.D. <br /> .... ; G�. ail <br /> ❑ or PO Box Na. � ...........•-J- livery?(F�tra Fee) 11 Yes <br /> f` •-- - l <br /> City.State,Z <br /> • <br /> PS Form 3811,February 2004 mstiDoec Return Receipt 102595-02-M-1540 <br /> '• . ON <br /> (Domestic Mail Only; .• ❑Agent <br /> rU R-Ad—d—,.ssee <br /> 03 <br /> Printed Name) C. Da of livery <br /> D-' Postage $ cress different from item 1? ❑ es <br /> delivery address below: D-M-6 <br /> Certified Fee <br /> r'-9 Postmark <br /> [Zl Return Receipt Fee Here <br /> O (Endorsement Required) <br /> 0 <br /> Restricted Delivery Fee <br /> � (Endorsement Required) <br /> ED n <br /> Fn Total Postage&Fees $ c �- <br /> � [�/ Bail ❑ Express Mail <br /> Z 1141 <br /> ent o j 0 Return Receipt for Merchandise <br /> O <br /> ------------------------------ tail [I C.O.D. <br /> $treat,Apt No.; <br /> or PO Box No. .� e1ivery7(Extra Fee) ❑Yes <br /> ------------ ---- '�� ._ :. .. <br /> City,State,ZIP+4 <br /> PS Form :ir 00. See Reverse for Instructions <br /> • Domesdc Return Receipt 102595-02-M-1540 <br /> PS Form 3811,February 2004 <br /> Postal <br /> SECTIONON DELIVERY <br /> CERTIFIED MAIL,. RECEIPT <br /> � F, (Domestic Mail Only; . ..• Provided) Agent <br /> ru , �` ddressee <br /> CO <br /> 7T(P'nte <br /> Na e) ajeXelivery <br /> !lr <br /> Q- Postage $ ❑Yes <br /> ul jdress different from item 1. <br /> Certified Fee r delivery address below: ❑ No <br /> Postmark <br /> Return Receipt Fee Here <br /> M (Endorsement Required) <br /> D <br /> Restricted Delivery Fee <br /> (Endorsement Required) <br /> O — <br /> M Total Postage&Fees $ / �( g <br /> r r (f <br /> Sent to I Mail ❑ Express Mail <br /> ed ❑ Return Receipt for Merchandise <br /> / 4 gt'-!_r!1 f17 L��1.[l ./_ ./I-....... Mail ❑ C.O.D. <br /> or PO Box No. f�< �� �_��,/ Delivery?(Extra Fee) El <br /> City,State,ZIP+4 r"I <br /> PS Form :0r August 2006 See Reverse for Instructions <br />