SIGNED CERT. MAIL FORM FOR 162 1/2 NORTH ST SENDER: COMPLETE THIS SECTION COMPLETE THIS SECTION ON DELIVERY
• Complete items 1,2,and 3. A. Sign- re
• Print your name and address on the reverse ❑Agent
so that we can return the card to you. XA ID Addressee
• Attach this card to the back of the mailpiece, B ceive��� ! Date •of r eliv ry
or on the front if space permits. .� • V • 5 l6 /,
1. Article Addressed to: D. Is delivery address different from item 1? ❑Yes
If YES,enter delivery address below: ❑ No
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PCL- I of 6110
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1111 III 111111 II I I I 1 II I I I 3. Service Type o PriorityMail Express®
0 Adult Signature ❑Registered Mail'.
❑Adult Signature Restricted Delivery ❑Registered Mail Restricted
❑Certified Mail® Delivery
9590 9402 1868 6104 9580 40 ❑Certified Mail Restricted Delivery 0 Return Receipt for
_ ❑Collect on Delivery Merchandise
2. Article Number(Transfer from service label) ❑Collect on Delivery Restricted Delivery 0 Signature Confirmation'"'
7 017 1450 0001 5936 4364 sured Mail 0 Signature Confirmation
sured Mail Restricted DeliveryRestricted Delivery
, , ver$500)
PS Form 3811,July 2015 PSN 7530-02-000-9053 Domestic Return Receipt
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