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Home My WebLink AboutDOE_Receipt_SSDP_190619•Completeitems1,2,and3.•Printyournameandaddressonthereversesothatwecanreturnthecardtoyou.•Attachthiscardtothebackofthemailpiece,oronthefrontifspacepermits.A.Signature-•..-xB.Receivedby(PrintedName)IC.DateofDeiiverD.IsdeliveitDYesIfYESnterdeliveryaddressbelow:\QNo(\UN172019orityMailExpress®3.ServiceTyp\,1pt/.AduftSignatureRegisteredMailTMCAdultSignatureRestricReisteredMaltRestrictECCertifiedMail®DeliveryCCertifiedMailRestrictedDeliveryCReturnReceTptforCCollectonDeliveryMerchandiseOCollectonDeliveryRestrictedDelivery0SignatureConfirmationm—iCSignaturnConfirmationlRestrictedDeliveryRestrictedDeliverySENDER:COMPLETETHISSECTIONCOMPLETETHISSECTIONONDELIVERYDAgentDAddressee1.ArticleAddressedto:S1aeD%oOfcQ2)190d\Q\Ju-jJPrOOIIIIIIIIIIIIIIIIIIIIIIIIIIWIII95909402459082789074522.ArtIcleNumber(Transferfromservicelabel)701&0040000016967034PSForm3811,July2015PSN7530-02-000-9053L.V\O’DomesticReturnReceipt