Laserfiche WebLink
-Permit#: _ _ ~ Confidental?: <br />Class: Type-Seq.: <br />From: To: i <br />Doc. Name. 5 <br />Doc. Date (if no date stamp): Gag-c~ <br />^ Complete items 1, 2, and 3. Also complete <br />item 4If Restricted Delivery is desired, <br />~ Print your name and address on the reverse <br />so that we can return the card to you. <br />- ~ Attach this card to the back of the mailpiece, <br />, or on the front if space permits. <br />1./~~A//rticle Addressed to: <br />• /!5`34 c /Q <br />~~`~~',~ e ° a~~a~ <br />O y~yem <br />by (Printed Name) ~ C~ Date of <br />address d'dferem from aem 17 ^ Yes <br />ter delivery address below: ^ No <br />3. Service Type <br />~Certifled Mall ^ f~ra5s Mail <br />^ Registered .~Retum Receipt for Merchandise <br />^ Insured Mail ^ C.O.D. <br />4. Restricted Delivery? (Extra Fee) ^ yes <br />2. Article Number <br />(rmra/er riom seMCe labeQ 7002 2410 X005 9145 921 <br />PS Form : 'T1, August 2001 estlc Return Receipt to25ssoz+n-t5ao <br />r_ <br />~f. <br />~] CERTIFIED MAIL.a RECEIF <br />(Domestic Mail Only; No Insurance Coverai <br /> <br /> <br />D" <br />roemae <br />f <br /> <br />O <br />~' <br />Certlfle0 Fee 2 ~j <br />• - ~-_~ <br />. <br />o . <br />. <br /> ea ue<v - ; S~ ~~ <br />C <br />~ <br />s Restrlcled Delh~ery Fee <br />(EndoreeereM Repaired) ~' <br />r ~ ~1. s <br />JUN x\ ! <br />~ roml roetava a Fees $ , ~( <br />. 29 y j <br /> ~ <br />o <br />M1 N~y <br />__ <br />!a7ae~-~`:`IZ!a+f"~u~2I. `` <br />~d~~ qa/ .rt <br />_. ._...__ .e._.._t..c____.__.__._> <br />