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m SENDER: <br />v •Complete items 1 anNor 2 far additiorW services. <br />m •Complete items 3, Ia, arM bb. <br />a • Print your name and address an the reverse of this lone so Jhat we can return this <br />card to you. <br />> •Attach this loin to the troll of the mailpiece, or on the back it space tloes not <br />permit. <br />Y •Wnte'Rerum Receipt Hequestetl'on the mailpiece below me article number. <br />•The Return Receipt will show to wham the article was delivered and the dale <br />~ delivered. <br />O <br />v 3. Article Addressed to: <br />CJ~9.o t'GdC~ Q ~a.r r t C ~ <br />W Z'lD S l 5'u"' S~ <br />c n L`;L,~-1,~~4jCblZIZ-poop <br />a <br />z <br />F 5. Received By: (Print Name) <br />W <br />g 6. Signa (Addressee Agent) <br />o X <br />T <br />n <br />,D~ <br />~~ <br />I also wish to receive the <br />following services (for an <br />extra fee): <br />1. ^ Addressee's Address <br />2. ^ Restdded Delivery <br />Consult postmaster for fee. <br />^ Registeredr ~,*,( CeP.ified <br />^ Fxpress Mail ~ pYnsured <br />^ Return Receipt for Merchantlise OCOD <br />and /ee is paid) <br />P 5 ~k11 328 <br />u ~ <br />e or Certified Mail <br />r e Coverage Provided. <br />a Inr Intwmwtinnal Mail /.Sww rwvwrtwl <br />r <br />.L <br />~ r <br />II L`C ~ <br />r <br />t a <br />. <br />T <br />{. ( <br />} <br />y <br />'. C.B I~Jr I C{ <br />~ <br />~ ~`~` ~ <br />P Olfice, Slate,8 ZI <br />n a ~ 1~ ~ N <br />Postage ~~ <br />Certified F99 !, ~' 3 <br /> <br />Spedal Dellve 'Fee h <br /> <br />Restricted Deli ~ Feu <br />i CC <br />~ d r <br />V <br />~ Return Receipt owing to <br />' d <br />i ~ <br />Whom 8 Dale De re0 <br />IkWm Rxeq~151c1i1q <br />F Dale,60dtreseeY a- <br />~C~ ,y~* G <br />CAD <br /> <br />TOTAL Postage 8 Fees <br />I S ~^ <br />I Posenark or Dek C <br />~ C <br />I n <br /> <br />0 <br />N <br />a <br />Y <br />U <br />m <br />Q <br />.n <br />s <br />0 <br />0 <br />T <br />c <br />L <br />F <br />