U.S. Postal Service ". CERTIFIED MAILrr., RECEIPT

U") (Domestic Mall Only; No Insurance Coverage Provided)

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Certified Fee fT1 CI Return Receipt Fee o (Endo!semenl Required)

o Reslrtcted Delivery Fee I----\------l o (Endorsement Required) fT1 I----~~~

<0 Tela! Postage & f United Automobile In·~,:::...:-rompany

r'l o-=c=.,....--- 1313 North West 167th Streetsen/To

<0 Miami Gardens, FL 32391 o Strii6Cilpr'NO:;'" ~ or PO So)( No. /I~Ot(;;[;)---0)S/frm f, Ti~~~=~~~

citY.-siSie,Z1p;r OJnd .A-e!mir;. ord' PS Form 3800 AugusI2oo6 See RC'll~"e Ie' InSltuelo0l15

SENDER: COMPLETE THIS SECTION COMPLETE THIS SECTION ON DELIVERY

A. Signature

Item 4 If Restricted Delivery is desired. • Complete items 1, 2, and 3. Also complete

x• Print your name and address on the reverse so that we can return the card to you. B. elivery

• Attach this card to the back of the mailpiece, or on the front if space permits.

,9: is.Flelivery address different from Item 1? 1. Article Addressed to: ., _.. . LI K'1~lf.lVEs, enter delivery address below: -- IJlLA~ ~ ,!\I,,~ '"

United Automobile Insurance Corlipany' 1313 North West 167tfi Street 01 2 Miami Gardens, FL 32391 •

JI~·otr J-d - i)/ $' !:rlt7n ~I OMsion !.!;:::::=========r., n ~ t1 A1 ' 3. Service Type LIP/V ' ~frf)~IfW· Mertified Mail o Express Mail

o Registered o Return Receipt for Merchandise

o Insured Mail o C.O.D.

4. Restricted Delivery? (Extra Fee) DYes

2. Article Number (Transfer from service label) 7008 1830 0003 9411 7705

PS Form 3811, February 2004 Domestic Return Receipt 102595·02-M-1540