[NDER

COMPLETE

THIS

SECTION

Complete

items

1,

2,

and

3.

Also

complete

item

4

if

Restricted

Delivery

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.

1.

Article

Addressed

to:

omi5

(QO

/L.

gna/

gent

C

Addressee

B.

Receiv’by

(

Printe

Name)

I).

Is

delivery

address

different

from

item

1?

C

Yes

If

YES,

enter

delivery

address

below:

C

No

I

3.

ervic

ype

ertified

Mail

C

Registered

C

Insured

Mail

102595-02-Mi

540

(DZO

75

DExyisMail

.Ketum

Receipt

for

Merchandise

C

C.O.D.

4.

Restricted

Delivery?

(Extra

Fee)

C

Yes

2.

Article

Number

(Fransferfromserv!celabef)

7008

2810

0002

2863

7167

PS

Form

3811,

February

2004

-

-

Dornesdc

Return

Receipt

C.

Date

Delivery

-

G_

Qp

APR

7

2Oog

•UNo

019

Qar

*

jiI.