WQ0005790_Delivery Receipt NOV-2023-LV-0410_20230705

■ Complete items 1, 2, and 3.
■ Print your name and address on the reverse
so that we can return the card to you.
■ Attach this card to the back of the mailpiece,
or on the front if space permits.
1. Article Addressed to:
Nc aN6S
11111111IIIINIIIIIIII
9590 9402 4435 8248 4494 36
7021 2720 0002 3808 2697
Ps Form 3811, July 2015 PSN 7530-02-000-9053
4
❑ Agent
❑ Addm:
D. Is delivery address different from Item 17 ❑Yes
If YES, enter delivery address below: ❑ No
Type
ignature
ig
❑ Priority Mall Express®
Ignature Restricted Delivery
d Mail®
❑ Registered Mail•M
❑ Registered Mall Restricted
d Mall Restricted Delivery
Delivery
❑ Return Receiptfor
on Delivery
MercharMise
on Delivery Restroted Delivery
❑ signature Conflrnatlon*M
Mail
❑ Signature Conflrnation
Mal Restricted Delivery
J
Restricted Delivery
Domestic Return Receipt