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SENDER: <br /> v -Complete items 1 and/or 2 for additional services. I also wish to receive the <br /> m •Complete items 3,4a,and 4b. following services(for an <br /> m s Prim your name and address on the reverse of this form for that vie can return this extra fee): <br /> card to you. o <br /> j -Attach this form to the from of the mmlpieos,or on the bad it space does not 1, ❑ Addresses's Address u <br /> Permit. <br /> sWnte'Retum Receipt Requested" the mailpiece below the article number. m <br /> m 2. ❑ Restricted Delivery w <br /> L, •The Return Receipt will show to whom the erdtle was delivered and the date <br /> delivered. Consult posirnaster for fee. .3 <br /> o •01 <br /> v 3.Article Addressed to: �" 4a.Article Number m <br /> d �ylyl Mot kG) e cfE/1Jcw <br /> E aIn� �� �jw�d 4b.Service Type <br /> V W m <br /> ��b��YL ❑ Registered Certified <br /> in YJ` ❑ Express Mail ❑ Insured E <br /> s� m <br /> ❑ Return Receipt for Merchandise ❑ COD <br /> 7.Date of Delivery <br /> 'o <br /> =Cc <br /> n 5.Received By:(Pdnt Name) 8.Addressee's Address(Only if requested <br /> It- <br /> w and fee is paid) r <br /> F <br /> g 6.Signatu dd ea or Agee <br /> T <br /> m <br /> PS Farm 8 1, December 1994 Domestic Return Receipt <br /> Z 41L 942 924 <br /> CeP4if• �I ch <br /> No Insu overage Provided CV <br /> Do not use for International Mail <br /> IS Rev rs CD <br /> O <br /> m sent tti • r <br /> a <br /> C s t anq d 5 �.. <br /> N <br /> 0 <br /> P are pna ZIP C <br /> C IIV11 <br /> mPostage $ <br /> CO <br /> p Certified Fee O` N <br /> IL <br /> Special Denvery Fee <br /> do <br /> r, <br /> Rewm Receipt Shown \. E <br /> to Whom&Data Delne <br /> Return Recoot showing t4 L <br /> Dale,and Addressee's Address <br /> TOTAL Postage $ Ch <br /> &Fees r <br /> Postmark or Date C'7 <br /> T <br /> r r � <br /> rr = nur mspecten nn = not Appuceote <br /> WHITE - PUBLIC FILE YELLOW - OPERATOR PINK - CORRESPONDENCE FILE <br />