31B-167 (8) SENDER: I also wish to receive the
• Completeitems 1 and/or 2 for additional services.
• Complete items 3,and 4a&b. following services (for an extra
• Print your name and address on the reverse of this form so that we can fee):
return this card to you.
• Attach this form to the front of the mailpiece,or on the back if space 1. ❑ Addressee's Address
does not permit.
• Write"Return Receipt Requested"on the mailpiece below the article number. 2. Restricted Delivery
• The Return Receipt fee will provide you the signature of the person delivers
to and the date of delivery. Consult postmaster for fee.
3. Article Addressed to: 4a. Aicle Number
r Aq c) 3cb o-7 q
4b. Service Tag
Ll Registered 0 Insured
z� Certified ❑ COD
�i ❑ Express Mail ❑ Return Receipt for
Merchandise
7. D71D
to of Delivery
(p ;�—
5. Signature (Addressee) 8. Addre see's Address(Only if requested
and fee is paid)
6. Signa a (Agent)
PS Form 3811, November 1990 3- .s.opo:twt—m-m DOMESTIC RETURN RECEIPT
UNITED STATES POSTAL SERVICE
Official Business
PENALTY FOR PRIVATE
USE, $300
Print your name, address and ZIP Code here
� � � Y`\
P 890 36 094
RECEIPT FOR CER IF1ED MAIL
NO INSURANCE COVER, t PROVIDED
NOT FOR INTERNATIONAL MAIL
('See Reverse)
Street and r^
P O.Sta3�te end ZIP
Postage
Cert!tied f=ee '
Special Delivery Fee
Restricted Delivery Fee
Return Receipt showing
to whom and Date Deliver
U")
Return Receipts
trove jo
Date,and Address er G-
a TOTAL Postage a
0 Postmark or Date , .
o ��
LL
a ,
STICK POSTAGE STAMPS TO ARTICLE TO COVER FIRST CLASS POSTAGE,
CERTIFIED MAIL FEE,AND CHARGES FOR ANY SELECTED OPTIONAL SERVICES. (see front)
I If you want this receipt postmarked,stick the gummed stub to the right of the return address leaving
the receipt attached and present the article at a post office service window or hand it to your rural carrier,
(no extra charge)
2. It you do not want this receipt postmarked,stick the gummed stub to the right of the return address of
the article,date.detach and retain the receipt, and mall the article.
3. If you want a return receipt,write the certified mail number and your name and address on a return
receipt card,Form 3811,and attach It to the front of the article by means of the gummed ends if space per-
mits. Otherwise,affix to back of article. Endo-se front of article RETURN RECEIPT REQUESTED
adjacent to the number.
4. If you want delivery restricted to the addressee,or to an authorized agent of the addressee,endorse
RESTRICTED DELIVERY on the front of the article.
5. Enter fees for the services requested in the appropriate spaces on the front of this receipt if return
receipt is requested,check the applicable blocks in item i of Form 3811,
6 Save this receipt and present It if you make inquiry.
U.3.G.P.0.1987.197-722