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III IIIIIIIIIIIII III <br />999 <br />~~„ SENDER: <br />9 Complete aema 1 ardor 2 for additional services. 18150 Wish to receive the <br />a •Complete items 3, 4a, aM 4b. fOIIOWIng SBrVICBS (}Or 8n <br />n •Pdnt your name and address on the reverse of this form so that we can return INS B%Ir8 fBB): <br /> Card 10 yea. CI <br />j •Aaach this form to the horn of the mailpiece. or on the betlr it space does nm t <br />^ Addfessee'S AddrBSS ~ <br /> permit. , m <br />' o • Wdle'Refum Receipt Requested'on ttre mailpiece below the article number. Q. ^ RBStnCfed DellVery y <br />$ • The Return Receipt rill show to wham the artitle was delivered and the date <br />~ delivered. Consult postrnaster for fee a <br />0 <br />a 3. A, rticle Addressed to: <br />v o'"r^- ' A F~~f~ <br />a <br />~a~z~D Cxc 3~ <br />~ s. sign <br />r X <br />m <br />PS Fonn <br />or <br />1, December 1994 <br /> .~ <br />mcle N tuber v <br />~ <br />~a~ 3 <br />s <br />4b. Service Type <br />d <br />^ Registered Certified <br /> <br />^ Express Mail Insured ` m <br />. <br />^ Return Receipt for Merchandise ^ COD ~ <br />7. Date of D livery <br />9 <br /> <br />~ <br /> . <br />8. Addressee's Address (Only i/requesred ~ <br />and !ee is paid) t <br /> F <br />P 21 31`626 <br />e <br />~. ace' or Certified Mail <br />No I rance Coverage Provided. <br />~~'~tD not use for Intematlonal Mail See reverse <br />rn <br />0 <br />O <br />li <br />a <br />no <br />S1re Numbs <br />ice, rate, 8 ZI e , <br />Postage <br />Certified Fee <br />Spedal Delivery Fee - <br /> <br />~ -.~ <br />r <br />Resided Delilery F ' ~ <br />.` - <br />,. ~ <br />' <br />~~C; <br />Rehm Recdpl S p (q <br />Whom 8 Date DeJverad <br />.-. <br />oa~re, as ~m '~Pemassc - ~ IJ ~ <br />TOTAL Postage 8~eee 3 ,/ <br />Posbnark or Data ~ = ~ ~'-~ <br />-~: <br />W <br />W <br />CD <br />7 <br />N_ <br />O <br />fD <br />m <br />n <br />O <br />N <br />0 <br />n Receipt l <br />Q~ .l <br />U <br />0" <br />/~ <br />ti <br />~yL <br />