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■ Complete items 1, 2, and S. A. Signature '-- -- <br /> 0 Agent <br /> ■ Print your name and address on the reverse dressee <br /> so that we can return the card to you. B. � 'Rec d ❑t pram C: Da1Delivery <br /> ■ Attach this card to the back of the mailpiece, akeu <br /> or on the front if space permits. Chl <br /> 1. Article Addressed to: D. Is delivery address different from item 1? 0•YIs <br /> /S��I �' If YES,enter delivery address below: C110 <br /> S-rlme C,Lr4lz 1 <br /> ('Z-'C Sf,'Z VA-7 1OF4 Ir71 t a►•t N <br /> P,6.5 c-Yx � 21 � <br /> I-qO 4c) c U L U fur 6 9 <br /> 3. Service Type { Priority Mail Expresso <br /> El Adult Signature A . . Registered MalITM <br /> III HE 111111111 H ❑ Adult Signature Restricted DellvQ y o Registered Mail Restricted <br /> XCertified Mail@ 'Delivery <br /> 9590 9402 5696 9346 6084 62 ❑ Certified Mail Restricted Delivery 0 Return Receiptfor <br /> 13 Collect on Delivery Merchandise <br /> ❑ Collect on Delivery Restricted Delivery ❑Signature ConfirmationTm <br /> 2. Article Numb r,�ransfer from service label El Insured Mail ❑ Signature Confirmation <br /> �7©2 21 b 70 OC IG2 L`7 S"3 � ��� ❑ Insured Mail Restricted Delivery Restricted Delivery <br /> (over$500) <br /> PS Form 3811, July 2015 PSN 7530-02-000-9053 Domestic Return Receipt <br />