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!~ <br />i(Ly <br />^ Prj <br />SU <br />^ AM <br />or <br />1. Arli <br />ga~ rv. <br />2. <br />i <br />3. Also complete A. Received by (Plesse Prinr C/edrA., g, gate_o~ Duel <br />ry is de:tired. 71 11 1R ~C C [M <br />ess on the reverse <br />card to you. C. Si nature p ~ <br />~k of the mailpiece, ~.`Wvd'ls~'/(I p pgont <br />rmits. ~ Addte <br />D. Is tlelivery address diNerent tmm item 77 -^ Yes <br />r If YES, enter delrvery address below: ^ No <br />~Q 7 <br />V v T''L <br />// <br />// <br />!! <br />~R"~~ ~--!! 3. <br />rvice Type <br />S <br />e <br /> .. <br />~s <br />v... <br />.C-c:ertifed Mail ^ Express Mail <br /> ^ Registered ^ Return Receipt for Merchandise <br />~~V3 I O Insured Mail ^ C.O.D. <br /> 4. Restricted Delivery? (Extra Fee) ^ Yes <br />Domesec Return Receipt <br />i <br />.. ~. <br />P y36 7B4 357S,q„ <br />I~1S Postal Service / `~ <br />'4teceipt for Certified ~ ~ ~ <br />~Jo Insurance Coverage Provided. <br />~JDo f t l t tional M 'I S <br />/~ <br />~~ <br /> rto use or n ema at ee reve <br />~ S 8NU }- <br />~ <br /> v <br />. <br />G <br />~ P,gs[f~fice, WI d <br /> 7lOT ` <br />v / r <br />C <br />2 Certifi e <br /> <br />~~....r-r <br />•II Spedal Delivery Fee <br />C Resuide0 Delivery Fee <br />•+n <br />~' <br />~ Retum Receipt Stvwrimp to <br />N7rom d Date Defixered~ <br />- S <br />. ReLm Receip, <br />Dam,6Atldesae's c <br />~ J <br /> TOTAL Poste 8 5 5~ <br /> <br /> <br />cc <br />Gc Posenark or~er 1 ~ <br />T <br />~ <br />bf~ <br />~s <br /> g6 <br />t02595-0P~L17BB <br />.~.j <br />~,~,~~~ .6. ,~Lu~~~.; . <br />