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m <br />9 <br />m <br />O <br />0 <br />0 <br />m <br />0 <br />d <br />a <br />E <br />0 <br />U <br />~Completditems 1 endror 2 for etlditional eervicea. 18150 Wlsh to reCBiVB thB <br />•Complete items 3, 4a, and 4b. }OIIOWIng SerVICBe (fOr 8n <br />•~~; our <br />u ame and address on the reverie of this brm so that we can return this extra fee): <br />o ~ <br />•Atlach this form to the honl of the mailpiece, or on the bad it spate does not } <br />^ Addressee's Address <br />permit. , ~ <br />•Wdte'Re(um Receipt Requesled'on the mailpiece below the adide number. 2. f]Restdcted DBliVBry y <br />•The Relum Receipt will show to wham the snide was tleliveratl antl the date <br />tleliverea. Consult posbnaster for fee <br />~r s~lu~ ~~~~+~ <br />UIC,~ZfY CD ~11Y~0 <br /> m <br />4a. Article Numb r <br />~ a a7~ m <br />z <br />4b. Service Type <br /> <br />^ Registered Certified d <br /> <br />^ Express Mail ^ Insured OI <br />S <br /> <br />^ Return Receipt for Merchandise ^ COD n <br />7. Date of Delivery <br />~ 9~ <br /> <br />a <br />B. Addressee's Addr ss (Only it requested ~ <br />end !ee is paid) t <br /> 1- <br />~ s. signature: (addressee or Ager <br />T <br />y X~~v\~`-3 <br />PS Forth 3811, December 1994 <br />