HomeMy WebLinkAboutCertified Mail Receipt - OT General - 9/11/1981 P21 9863420
RECEIPT FOR CERTIFIED MAIL
NO INSURANCE COVERAGE PROVIDED—
NOT FOR INTERNATIONAL MAIL
(See Rey e)
SENTTO
Sfifil E D
f\P...Q/STATE AND ZIP CODE
Cf3S/
POSTAGE $
CERTIFIED FEE ¢
SPECIAL DELIVERY ¢
RESTRICTED DELIVERY ¢
LL
SHOW TO WHOM AND-
DATE DELIVERED
w h SHOW TO WHOM,DATE,
y J AND ADDRESS OF ¢
R a DELIVERY
= W
o w SHOW TO WHOM AND DATE
ir
°C DELIVERED WITH RESTRICTED ¢
z o ¢ DELIVERY
SHOW TO WHOM,DATE AND
ADDRESS OF DELIVERY WITH ¢
�p RESTRICTED DELIVERY
rn
-- TOTAL POSTAGE AND FEES $ 5 3
a POSTMARK OR DATE .
Q
g'
0 ��
I
STICK POSTAGE STAMPS TO ARTICLE TO COVER FIRST CLASS POSTAGE,
CERTIFIED MAIL FEE,AND CHARGES FOR ANY SELECTED OPTIONAL SERVICES.(see front)
I
1. If you want this receipt postmarked,stick the gummed stub on the left portion of the address side of '
the article,leaving the receipt attached,and present the article at a post office service window or
hand it to your rural carrier.(no extra charge)
2. cif you do not want this receipt postmarked,stick the gummed stub on the left portion of the address
side of the article,date,detach and retain the receipt,and mail the article.
3. If you want a return receipt,write the certified-mail number and your name and address on a return
receipt card,Form 3811,and attach it to the front of the article by means of the gummed ends if space
permits.Otherwise,affix to back of article.Endorse front of article RETURN RECEIPT REQUESTED
adjacent to the number.
4. If you want delivery restricted to the addressee,or to an authorized agent of the addressee,
T endorse RESTRICTED DELIVERY on the front of the article.
5. Enter fees for the services requested in the appropriate spaces on the front of this receipt.If return
receipt is requested,check the applicable blocks in Item 1 of Form 3811.
6. Save this receipt and present it if you make inquiry.
� GPO:1979 302-878
eJ
u5 ®SENDER: Complete items 1,7.,and.3.
Add your address in'the"REISJRN TO"space on
7
reve7se.
The 01owing service is requested(chack one.)
❑ Show to whom and date deiiv,:--d............—it
ElShow to whom,date and address of deliroery...—ti
a ❑ RESTRICTED DE,UVERY
Show to whom and date deliveTcd............�
❑ RESTRICTED DELI ERY.
Show to whom,date,and adRsi"pf dqfivM-.$/c
(CONSULT POSTMASTER FOR FEES)
2. ARTICLE ADDRESSED,/�YY 'J:U 1
70 ;�.5 \/O yQ
5 1v8P_dire, OJA g Y 3 8 --!s
n 3. AFMCLE`DESCRiMIGN:
n1 REGiaYERED NO. GEfiTIR1ED NO. I INSURED NO.
sa (Always ays olatnin sknatsre of addressee or agent)
i7
I have received the article described above.
S!GNATURE CJAddreswe OAuthorized agent
�. ATE OF DELIVEnY OGTMAR
E. ADD.R-E;.S iComp!eta cr3y if requested)
tst '0
o. UNABLE TO DELIVER BECAUSE: CLiR
p IALS
i
i
JNITED STATES POSTAL SERVICE
OFFICIAL BUSINESS
PENALTY FOR PRIVATE
SENDER INSTRUCTIONS USE TO'AVOID PAYMENT I
Print your name,address,and ZIP Code in the space below. OF POSTAGE.M
IR:�.rliRlL �
® Complete items 1,2,and 3 on the reverse.
• Attach to front of article if space permits, I
otherwise affix to bask of article. -
• Endorse attildo"Return Receipt Requested"
®bjacent to number. I
RETURN
TO y,
(Nartte of Sender)
I
I
(Street or P.O.Box)
i
(City,State,and 21P Code) +