WQ0005173_Delivery Receipt LV-2023-0207_20230817

■ 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 mailplece,
or on the frontifspace permits.
1. Article Addressed t
A. SI
❑ Agent
X
.
B. e d by (Printed a
.Addressee
C Dat of DelveD.
Is delivery address ran
t from Item 17 Oyes
If YES, enter delivery a dress below: �p No
3. Service Type
0 Priority Mail
I
IIII
III
III'I�III
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l II
I I IIIIII
IIII
Restricted Delivery
❑ MaPRes®cted
9590 9402 7703 2122 0278 70
- >A Certified Mat re
❑ Certified Mail Restricted Delivery
DRe$Ist�red
live
❑ signature Confirmation*m
❑ Collect on Delivery
❑ Collect on Delivery Restricted Delivery
❑ Signature Confirmation
Restricted Delivery
2. Article Number (rrana(er from service label)
^ Insured Mail
7021 2720 0002 3808 3892
°
Insured Mall Restricted
e $5
I PS Form 3811, July 2020 PSN 7530-02-000-9053
Pomegtic Return Receipt
I