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L <br />r z -130 0~ 31 <br />US Postal Service (~~ ~~'®~ ~ <br />Receipt for Certified Mail s--~ <br />No Insurance Coverage Provided. ~.' <br /> <br />a <br />m <br />Q <br />O <br />W <br />M <br />LL <br />y <br />a <br />o not use for In n ational Marl See reverse <br />0 <br />er ~r ~ Q <br />( <br />swe, code <br />-~ <br />P~,age S <br />Certified Fee <br />Spedal Delivery Fea <br /> <br />Rastdded Delivery Fee ter. <br />tj;,C FU! <br />Rehm Recdpt Showing 1 <br />VVhan 8 Data DeGveretl ~ + ~ S~. <br />Ream Rexpl9pailp to <br />Dale, 8 MAessee's ' J' I <br />U <br />TOTAL Postage 8 F <br />Postmark w Dale n <br />_ <br />~' •' <br />~SN~a !'. <br />fin- .. <br />l- <br />4 <br />C <br />t. <br />~' <br />~_ <br />U. <br />G <br />lt9 <br />-•r <br />C`J <br />L.: <br />°~ <br />O SENDER: <br />Complete items 1 anNor 2 for additional services. <br />18150 wish to fBC@IIB the ~, <br />'m •Complete items 3, 4a, and 4b. 1011owing SefviCOS (fOr en <br /> • Print your name eM address on the reverse of this form so that we can return this BXtm fBB)' <br /> card Io you. <br />m •Adach this tone to the horn of the mailpiece, or on the Lack if space does net t, ^ AddrB55BB'S AddrB55 <br /> <br />`y permit. <br />•Wdte'Rerum Receipt Requesrod'on'the ma+lpiece below the artide numr lc <br />2.^RBStRCfed DBhVBry ~ <br />y <br />t. •TTe Rerum Receipt will show to wham iha snide was delivered and Ne date ~ <br /> delivered. Consult postmaster for }ee. <br /> <br />~, <br />g 6. Signature: eon <br />o ~ <br />T r <br />N <br /> m <br />4a. Article Number <br />BC <br />~ d <br />7 13~ o <br />~ <br />l~ <br />4b. Service Type ~ <br />u <br />^ Registered ^ Certified <br /> <br />^ Express Mail <br />^ Insured a <br />c <br /> <br />^ Return Receipt for Merchandise ^ COD m <br />7. Date of Deliv ry E <br /> <br />'"" <br />~ 0 <br />o <br />J >+ <br />8. Addressee's A dr s (Only i/requested ~ <br />and lee is paid) r <br /> f <br />PS Fonn 381 T, December 1 <br />