A.
Signure -'

ReivbYfrm7teme)

o Agent
o Addressee

0 Express Mail

Li Yes
0 No

C. Date of Delivery

D. Is delivery address different from item 1?
If YES, enter delivery address below:

o Certified Mail

3. Service Type
0 Return Receipt for Merchandise
0 C.O.D.

102595-02-M-1540

0 Yes

o Registered
o Insured Mail
4. Restricted Delivery? (tra Fee)

Domestic Return Receipt

1eceved & lnspecte{

C4

me, address, and ZIP+4 in this box'

BUD

YV5V

First-Class Mail
Postage & Fees Paid
usPs
Permit No. G-10

7004 1160 0E100 2620 6472

653

jt.

• Complete item 1, 2r.d-S. Also complete
item 4 if Restricted Dljrery is desired.
• Print your name and address on the reverse
so that we can return the card to you.
• Attach this card to the back of the mailpiece,
or on the front if space permits.

44

1. Article Addressed to:

O.

La.or-kCk
2. Article Number
(Transfer from sep/ice label)

PS Form 3811, February 2004

UNITED STATETWtSØ

2& JUL iô

FPI 4 1.

ne

'Sender: Please print you

Ar
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4k5 2-

AUOU 2016
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