NCS000504_FV NSW MS4 Memo Green Card_20190108

■ Complete items 1, 2, and 3. Also complete .
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❑ Agent
item 4 if Restricted Delivery is desired.
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❑Addressee
■ Print your name and address on the reverse
so that we can return the card to you.
the back of the mailpiece,
-
a. ceived by (Printed Name)
C. Date of Delivery
■ Attach this card to
.et�cJ
or on the front if space permits.
D. Is delivery address different from item 17
Yes
1. Article Addressed to:
If YES, enter delivery address below:
❑ No
Mr, r`�,<jau\ M ACke-o
rMwn.Y.�„� i1
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3. Service Type
Lf U 1.1 .SUS 1�,4„C .
t�Certi Certified Mail ❑ Express Mail
for Merchandise
_ U
Registered ❑ Return Receipt
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❑ insured Mail ❑ C.O.D.
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4. Restricted Delivery? (Extra Fee)
❑ Yes
2. Article Number ?008 1300 0000 1124: 4153
(transfer from service Iabel)
PS Form 3811, February 2004 Domestic Return Receipt
102595-02-M-1540
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