•

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.

ArticleAddressedto:

9/4/08

B.M.

A.

Signature

DAgent

A_j

D

Addressee

B.

Received

by

(Printed

Name)

.

te

of

Delivery

I

l.

L

14

M

(ZG?f

D. Is

delivery

address

different from

item

1?

7es

If YES,

enter

delivery

address

below:

D

No

3.

Service

Type

ertified

Mail

Registered

D

Insured

Mail

SENDER

COMPLETE

THIS

SECTION

COMPLETE

THIS

SECTION

ON DELIVERY

PCB

200—16

Wi11iaWarren

2890

cextors

Drive

P

0

B

189

Ca1

62231

D

Express

Mail

D

Return

Receipt

for

Merchandise

I

D

C.O.D.

4.

Restricted

Delivery?

(Extra

Fee)

D

Yes

2.

Article

Number

(rransferfromser.’iceIabeI)

7007

3020

0000

4630

7276

\PS

Form

3811,

February

2004

Domestic

Return

Receipt

102595-02-M-4

540