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<br />o SENDER: <br />9 •COmplete'nema 1 enNw Z far edd'iaorml wrvka•. <br />a •Cornplate items 3. M, end M. <br />9 •Pdrt your name xW addteae m Ne tevena of tMe 1wm ao tltat we can retain tNe <br />C wd to you. <br />~ •Atteoh mie brm to the hom of the mdlpiea, or an the Detlr H specs does nw <br />/° permit. <br />o • Wdte'Rerum Reasipr Reauesfed'on the meilpiece below Ne eNGe number. <br />sr •ThB R•tum Receipt wiH show to whom the arlltla was tlalNared end the tlele <br />C delivered. <br />a 3. Artlcle Addressed to: 4e. Artlcle Nl <br />n ~,N e1c1 oV~ A I~ri I ~ - Z~ <br />E CD~ , ~~{ ~ -(tZi(15~(X~+ ~ ab. Service ~ <br /> <br />I also wish to receive the <br />following seMCes (for an <br />extra lee): <br />1. ^ Addressee's Address <br />2. ^ Restdcted Delivery <br />Consultpostrnasterforfee. ~' <br /> $ <br />33 ~ 12 ° <br />E <br />Certified ~~' <br /> <br />frchandse ^ COD ~ <br />v u~1 q f h ^ Registered <br />~~ ~ ^ F~tpress Mail <br />G~ ~u nc-f 1(m l Cl7 g i~ U ~ ^ Resin Receipt fc <br />7. Date of Deliv~Y <br />I~ <br />5. Received By: (Print Name) 8. Addressee's Ad <br />G ~ and lee Is paid) <br />9 <br />0 <br />a <br />A <br />PSI <br />1 JU ;, <br />(Only i! requested ~ <br />3eceipl <br />Z 268 233^y~1C2 ' ' <br /> <br />US Postal Service <br />d of <br />t <br />f fe <br />Receipt for Cer <br />No Insurance Coverage Provided. <br />Do not use for Intemalio al Mail Sae reverse <br />Sent to ~ ^ ~ <br />N ~ <br />W <br />Streeto number ~~ ~ <br />~ ~ <br />W <br />, <br />PostDtfit ce, 5 e, ZIP C~ u~ <br />`` Sl V ~ <br />1D ~ <br />$ ~ <br />Postage ~ <br />CeNfed Fee <br />O <br /> <br />SPedat Delivery Fee <br />Resldtled Delivery Fee IV <br />i <br />yr <br />~ Relum Receipt n9 to \ ~ fJl <br />N9am 8 Dat alive Q <br />.6 ReNmR ~ Nwhoin, ~\ <br />t FD <br />G bate, 8 \ -~ <br />S TOTAL 8 .~ ~ ~ <br />~ Posenark r0 <br />O <br />LL gs6s-ab° O <br /> <br />N <br />a C7 <br />r.~ <br />