Laserfiche WebLink
~Pe~mlt#:,w-~~_}_~__ ontitle~al?. <br />Class: Type-Seq.:,~~ <br />From: ~ To: <br />Doc. Na ~ _ <br />Doc. Date rlf no date stamp):_~ a9_~__ <br /> <br />^ Complete items t, 2, and 3. Also complete <br />item 4 if Restricted Delivery is desired. <br />^ Print your name and address on the reverse <br />so that we can return the card to you. <br />^ Attach this card to the back of [he maiipiece, <br />' or on the front if space permits. <br />1. Article Atldressed to: <br />~.~~/~ ~' <br />G~a~t ,U,z~~ j~~A <br />i~t~s~/ //~~,~~j~/y~J- <br />2. Article Number <br />(rransler /rom service label)-. <br />PS Fomt 3811, August 2001 <br />A. Signature <br />8. Recaided by (Printed Name) ~ C. <br />Agent <br />D. Is delivery address diffen±nt from item 11 .U <br />If YES, enter delivery address below: No <br />ReR2g1~p4~ <br />3. Service Type ~/ <br /> <br />Certified Mail Q <br />1 ail <br />^ Registered ^ Return Receipt for Merchantlise <br />^ Insured Mail ^ C.O.D. <br />4. Restricted Delivery? (Extra Fee) ^ Ves <br />7002 241 005 9145 7942 <br />Domestic Return Receipt 102595-02-M4540 <br />.• <br />N ~ ~ <br />~ t,, <br />rv <br />BIQ-t~t3 ~e~n~t~• rer. . <br />°_ _ , ~~ <br />. p 1:ertlfled Foe -) -_ <br />o tom', <br />p Relum Redept Fee ~ . <br />(ErMmaerrrenl Required) - ~ /Spj11-x~. <br />~ Reatrktetl De6~ery Fee ' ~~A/ .1 <br />• ~ (EndoBemenl Required) - /< R s \. `, <br />ftl Tote) Postage & Feee $ ~, lP~ i rn ~~,~, ~"~ ' <br />N t , ro I <br />~-~- ~. y L <br />