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SENDER: <br />~ <br />t~ eC;ompteteittxne t arWor 2 for additbrel cervkes. <br />~ 18150 Wish t0 receivB fhB <br />w eComgetB itetlN 3, IB, end I6. - = '~OIIOWIng SBfVICBe (fflf 8n <br />yo ~neme and address an the reverse of this form eo 5re1 we cen retran tNe <br />w e sofa eXtre fBB): <br />t <br />s eAdach tYhie brtn to the hors of IM mrlpiau, or on theback if slj~a dose nm <br />1 <br />d Addressee's Address ~ <br />Y <br />pemtit. . Y <br /> <br />~ eWfile'Retum Receipt Hequesfed'on the mailpiaca below the afitle rxxrlber. <br />2.~Re5Mcted DaliVBry ff <br />dd <br />fj eThe Relum Receiq rill show to whom Ne snide ryas deFvxedrq ttwEWa <br />C delivefed. rinnSUlt posima5tef tOr feB. <br />O <br />icle <br />4 33. <br />Art <br />Add~ress to: <br />4a. ArCCI N rnber <br />\ <br />~ <br />~ <br />(' <br />\` A 4b. Service Type <br />~ = <br />u <br />" ^ Registered <br />,Certined p <br />P D <br />~ Q A ^ Express Mail ^ Insured ~ <br />Cl~ k <br />(~ ^ Retum Receipt for Merdtandlse OCOD ~ <br />~ <br />W ~ ~ ~ ~ 7. ate of t)eliv ry <br /> '~/ <br />i <br /> C , <br />5. Received By: (Print Name) 8. Ad essee's Address (Only i/requested ~ <br /> and (ee is paid) t <br /> t- <br />~ 6. S~ na>}rre: (Add ssee get <br />T <br />q <br />PS6G 8 , g9twnbsr 1891 <br />m <br />rn <br />r <br />O <br />c7 <br />0 <br />a <br />Z 19 2 • g <br />US Postal service F'~I # M-?~ ~'~ <br />Receipt for Ceri~iedidFarF--~ <br />No Insurance Coverage Provided. <br />Do not use for Intematiortal Mail See reverse <br />nt to <br /> ^ <br />L <br />9 <br />/t w <br />~ <br />/~ <br /> <br />P Olfire, State, 8 IP W <br /> V: <br />Postage ,S ~ <br />(D <br />C <br />fi <br />erti <br />ed Fee <br /> <br />Spedel DeMery Fee <br /> Z <br />Ftessided Delivery Fee <br />Rehm Receipt Showing to j <br />NTam 8 Date DeGveredy... ~ <br />i+ewn Reropt Ntaln, <br />~ <br />Data,BMaessea' ' <br />. <br />TOTAL P • ens / t ~ C <br />Postmark or eta ~ ~ ~ 1 ~ <br /> <br />" <br /> <br />~ti.. / <br />$~ <br />