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Certified Mail Returned
■ Complete Items 1, 2, and 3., , A. ■ Print your name and address on the reverse X so that we cad return the card to you. ■ Attach this card to the back of the mailpiece, B• or on the front if space permits. Janice Van Der 5 Mohave K Dr Ac.1-©n,M�\ (D1'720 III III II III IIIIIIIIIIIIIIII IIIIIIIIIIIII 9590 9402 5251 9154 9320 40 2. Article Number (Transfer from service label) 7019 0140 0000 9523 5633 Ps Form 3811, July 2015 PSN 7530-02-000-9053 D. Is delivery If YES, on 3. llD1!ofa mijv 1 b 2019 a. service type 0 Pdodty Mall Expross® 0 Aduft Signature 0 Registered Map*M D Adult Signature Restricted Delivery 0 Replstered Mail Restricted GYCertiped WHO Delivery 0 Certified Mail Restricted Delivery 0 Return Receipt for O Collect on Delivery Merchandise 0 Collect on Delivery Restdcted Delivery D Signature ConfirmatlonTM 0 Insured Mall 0 Signature Confirmation O Insured Mall Restricted Delivery Restricted Delivery Domestic Return Receipt I