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JUUNITEOSTATES
POSTALSERVICE®
Name and Address of Sender
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Adult Signature Required °Primly Mail Express
❑ Adult Signature Restricted Delivery ° Registered Mail
❑ CeNfied Mail ❑ Retum Receipt for
❑ Certified Mall ReS tedDelNery Merchandise
❑ Collect on De(COD) ❑ Signature Confirmation
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❑ Insured Mail ❑ Signature tio Confirman
❑ Prionty, Mail Restricted Delivery
U.S. POSTAGE PAID
SA12866 SPRINGS, NY
Affix Stamp h 12666
NOV 13 23
(for additional cc AMOUNT
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PS Farm 3877, January 2017 (Page 1 of 2) -Complete in Ink Privacy Notice: For more Imormanon on ucro Privacy Pmm:ca, v,ar.
PSN 753 02-00g-9098
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Firm Mailing Book For Accountable Mail
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❑ Carl Mail Restricted Delivery Merchandise
❑ Collect on Ca,ery(COD) ❑ Sgnature Confirmation
❑ insured Mail ❑ SgnaNre Confirma❑m
❑ PnoriN Mail Rsamxbd Delivery
Add,saee(Name. Street. City, Stale, B ZIP Code^')
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Postmark with Date of Receipt.
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