- A.
- x
ature
SENDER: COMPLETE THIS SECTION COMPLETE THIS SECTION ON DELIVERY
I
Received by (Printed Name) C.
- Date of Delivery
• Complete items 1, 2, and 3.
- Also complete
item 4 if Restricted Delivery is desired.
- • Attach this card to the back of the mailpiece,
or on the front ifspace permits.
- 4. Restricted Delivery? (Extra Fee) C Yes
2. Article Number
(rransfer from se,vice label) 7011
0110 0001 8270 4575
PS Form 3811, February 2004 Domestic Return Receipt lO2595-O2-M-1
C Agent
C Addressee
PCB 13-57,Etc,071613 GrnCrd 
