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Z 268 2$ <br />US Postal Service ~~.~ ~/y7fl-~/~ f.~ <br />Receipt for a tt <br />No Insurance Coverage Provided.cQ~ a orsel G-~ <br />G,erdGetl Fee <br />Sgeael Delivery Gee <br />~- <br />RrstdCed DeNvery Fae <br />(e c,J2S <br />e~~ <br />~~ <br />,~ 7 <br />a o~ <br />b <br />s _ Qh~ <br />t~.~~ <br />TOTAL Postage s Fees S <br />po5pnatk or Date <br />y <br />a <br />r1Y <br />G <br />m <br />O <br />+ri <br />N <br />f~ <br />E <br /> <br />M <br />r <br />M' <br />T <br />V <br />o SENDER: <br />s •Compete dame t enNOr 2 for addilioiul •ervicee. .. - I E150 wASh to recelVe the <br />a •ComplNe items 3, 4e, end eb. - .10110Wing SBrVICBS (for IYI <br />s • <br />P <br />nm <br />, o~ name end address on Ma reverse of this roan eo Met we can return true gKtra <br />fee): <br />C <br />i r <br />~ <br />d <br />Mia ronn to the horn of the meilpiece, or on the beck ii space does not <br />•~e <br />U i <br />1. U Atldiessse's Adtlres6 <br /> m <br />~ <br />• Wrile'Retum Reaei r Fequaered' on the mail ace below Me aM1ide number. <br />2. ~ RestrtdeC Delivery ~ <br />y <br />$ •T}y Return Receipt will Mow to whom the eNtle was tletivere0 end the tlate ~ <br />~ <br />0 dNrveretl. Consult postmaster for fee. <br />g 3. ArGCIe Addressetl to: 4a. Article Number m <br />S <br />~ <br />` <br />~ <br />z a b~ a.~3 i 5 <br /> ~ <br />~2~ <br />~ <br />-cti~ 4b. Service Type <br /> ~ ~" ~ ~ ~ <br />Ti~a~-E ~Fr~r~cl~-CL/ ^ Registered ' ~ Certified <br /> ~y y~ <br />a O ~O s'S J~-~ <br />-f~~ <br />^ Express Mail ~ , ^ Insured e <br />p <br /> / <br />~ <br />r~ f7/r7 ~ <br />~ <br />O <br />~ <br />a V / • p Rehm Receipt for MerdtenNse ^ COO <br /> ~p <br />O iZC~Q, <br />- 7. Dat of Delivery <br /> <br /> <br /> 5. eived By: (PAnfJJp~ B. Atldressee's Address (Only!(requested <br />end fee is pad/ ~ <br /> ~ <br />H ~ <br />~ 6. SXnahlr6: (/~{ddressee ar Agent) <br />e ~' <br />PS Fonn 3811, December 1994 102595-97-8-01]9 <br />