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• Compiete items 1 andlor 2 for additional services. <br />• Complete items 3, and 4,, & b. <br />• Print your name and address on the reverse of this form so <br />that we can return this card to you. <br />• Attach this form to the front of the mailpiece, or on the <br />back if space does not permit ? <br />. <br />? Write "Return Receipt Requested" on the mailpiece <br />the article number. <br />3. Article Addressed to: <br />6v-AX Q?? <br />5.-Signature (Addressee) <br />6. S?'yp?ture (Agent) <br />- V1.1 -A _r ` /2 _i <br />I also wish to receive the <br />following services (for an extra <br />fee): <br />1. ? Addressee's Address <br />next to 2• El Restricted Delivery <br />Consult postmaster for fee. <br />4a. Article Number <br />10619 74 /,? 21 <br />4b. Service Type <br />? Registered ? Insured <br />? Certified COD <br />? Express Mail '4' Return Receipt for <br />t`?{- []=' Merchandise <br />7. Date of Deliver.y'" <br />8. Addressee's AdSres (Only if requested <br />and fee is paid) <br />PS Form 381 9, aDctober 1990 *U.S. GPO: 1990-273-861 DOMESTIC RETURN REGEIPT <br />.-` <br />.?? ?