Extra Services & Fees
(continued))
6. Signature Confirmation
$
______________________
7.Signature Confirmation
Restricted Delivery
$
______________________
Registered No.
9.Date Stamp
1.Postage $
10.Customer Must Declare
Full Value
$
11.Received by
PS Form
3806, Registered Mail Receipt
Copy 1 - Customer
April
2015,
PSN 7530-02-000-9051
(See Information on Reverse)
For domestic delivery information, visit our website at
www.usps.com
®
Domestic Insurance up to $50,000
is included based upon the
declared value
. International
Indemnity is limited. (See Reverse).
To Be Completed
By Post Office
To Be Completed By Customer
(Please Print)
All Entries Must Be in Ballpoint or Typed
13.TO
12.FROM
8.Total Postage & Fees
$
Extra Services & Fees
2.Registered Mail
$
_________
3.Return Receipt
(hardcopy)
$
_____________
4.Return Receipt
(electronic)
$
_____________
5.Restricted Delivery
$
______