32C-120 (3) SENDER: COMPLETE THIS SECTION COMPLETE THIS SECTION ON DELIVERY
• Complete items 1,.2,and 3.Also complete �"" • Signature
item 4 if Restricted Delivery Is desired. ❑Agent
• Print your name and address on the reverse X ❑Addressee
so that we can return the card to you. B. Reeelved by(Printed Name) C. Dat of De)ary
• Attach this card to the back of t e al lecg,
or on the front If space pem / ��B 3
t Article Addressed to: /// D. Is delivery address different from item 1? ❑Ye
��,��2� /) If YES,enter delivery address below: ❑No
,
3. Service type
`l2 e
.,(� ( / CI Certified Mail ❑Express Mail
�iQ�/- 0 Registered ❑Return Receipt for Merchandise
to j ID 17 ❑Insured Mail ❑C.O.D.
/ < 4. Restricted Delivery?(Extra Fee) ❑Yes
2. Art 7012 1640 0001 0833 3171
PS Form 3811,February 2004 Domestic Return Receipt 102595-02-M-1540
U.S.Postal ServiceTM
CERTIFIED MAIL. RECEIPT
r-a (Domestic Mail Only;No Insurance Coverage Provided)
r-
r3 For delivery information visit our website at www usps come
pr �..� i. eJ 1 Or i4:. t2 V
stage $
O
C rtlfled Fee
p Return Receipt Fee
Postmark
(Endorsement Required) • Hem
x .
Restricted Delivery Fee ._
(Endorsement Required)
O
-o Total Postage&Fees $
ll
rq --Street,Apt.No
t7 or PO Box No, "(p!
M1 Ci ate '+
.. .�, ., er e67.017
PS Form 3800,August 2005 See Reverse for Instructions