X DAgent /cy-r74’I ID2.o1.—--2 Addressee Recei’ 5 e by (Printed Name) C.
ate
of Delive __ .‘//i) D.
Is delivery address different from item 1?
D Ye If YES, enter delivery address below: U No 3.
ServiceType
ertifled Mail U ExpressMail Registered C Return Receipt for Merchandise C InsuredMail C COD.
I Print your name and address on the reverse
so that we can return the card to you. A 1. Article Addressed to: 7/11/13 B.M. AC 2013—044hz Raymond Burns 117 Vine Stieet P.O. Box 596 Sandoval, IL 62882 / PS Form 3811, February 2004 4. Restricted Delivery?
Allowed
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