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Z 734 612 567 <br /> � Receipt for <br /> Certified Mail <br /> e No Insurance Coverege Provided <br /> �..�o� Do not use for International Mail <br /> ISee Reversa) <br /> sem�o <br /> L �epy: 4 <br /> slmetana No. <br /> O OG/VL" N/�9Y $4/TF <br /> a o.,sm�o a�a zie coae <br /> S�c �e= 9&io/-l� <br /> PostaBe � <br /> Carlilio0 feo <br /> Special Oe:ivery Fav <br /> Pesvictetl Daiivery Fee <br /> m <br /> � floWm qecolp15nowinp <br /> to Wnom 6�ata Dolivere0 <br /> t <br /> � Pewm Peceipt SM1owing to W�om, <br /> A Da�e,enG AGE�es<eo'e AdC�ess <br /> � TOTAI Pas�aBe � <br /> p &Fees <br /> � Poslmark or Daie <br /> � <br /> tl/ <br /> € � - /O - �� <br /> 0 <br /> y <br /> � <br /> a <br /> •SENDER::o.nplete irems t and 2 when additionei servicns are decired.end completa itame 3 end 4. <br /> @ Put your address in the"RETURN TO"space on the revarie side.Feilure,o do thif wll�nravent thll <br /> . { �. cerd from 6eing returned to you.The retum recoi t teo will r vlde ou the neme of the non � <br /> � . deliverod to and the dete of deliverV. or a dit�one fee�t e a ow n8 sarvices are eva e a. ons�l[ <br /> � puctme— 'ster�laec and check boxlecl for edditional servicels)requettnd. <br /> � 1, ❑ Show to whom deliveied,datn,end eddressee'c addresc. 2. ❑ Ractricted Delivery. <br /> 3.Article Addresaed to: 4.Anlo a Numb�r <br /> z. J3 G/ S6 <br /> � f�/�'!10 L Q l3 e� �' �'n'aN r 7 Type o}Service: <br /> �a O O L , v ` i,,i p y {� Registerud Intu�ed <br /> �9 Cnrtlfled CtlD <br /> S N /T� /3 o O 9 Ll Express Mail <br /> �,Lr�'r T L L w� �' /p� -l��` Alweys ob2aln dgnaiure ot•ddreew�ot <br /> agant end DATE DELIVERED, <br /> 5,Signeture—Addressee 8.Addreseoe's Addre�s/ONLYIf <br /> X requested mid fec puidJ <br /> 6.SiBnature—Agen: ,-� • <br /> X � � � <br /> 7.Date of Deliver . . <br /> \ <br /> �S Form 3811,Feb.19 6 DOMES7IC RETl1pN RECI <br />