Laserfiche WebLink
! <br /> ,~ <br /> M-~o-» <br /> <br />o <br />a SENDER; <br />•~omplete item 1 enNor 21w adtlttiotW •ervicea. <br />~ <br />18150 Wish t0 receive the <br />m •COmplete items 3, Ia, entl 4b. ~ }0(IOtrring SBfviCBS (10f 8n <br />m <br />~ •pdm yow name end etltlress on Me reverse of This knn sc that we <br />t can return this Bxtra 18B): <br /> <br />!: o you. <br />rard <br />•Attech this /ortn ro the fives of Fhe rnailp(ece, or on the bait it space does not <br />rvt <br />y, ^ AtldresseB'S Atltlress <br /> <br />d . <br />~ perr <br />. <br />•Write'Aerum Receipt Requested' on the maepiece below Ne artitle number. Z„J] Restdeted DBIiYBfy y <br />~ •The Return Receipt will show to whom the ankle was delivered end the tlae <br />~ delnered. Consult postmaster for fee. a <br />0 <br />~ <br />a 3. AN <br />CIe A <br />ddres <br />sed to <br />: ~ 4a. Article Number s <br />i - <br /> <br /> ~ <br />~ <br />~ <br />/ <br />a <br />E <br />u <br />1 / <br /> <br />~~CA ra~ 1 <br />4b. Service ype <br /> <br />^ R <br />i <br />t <br />d C <br />ifi <br />d <br />~ . <br />m <br />~ <br /> ere <br />eg <br />s <br />ert <br />e <br /> ~k?0. ly-f <br />^ Express Mail ^ Insured <br /> <br />m <br />` - <br /> ~1,~ ~~11 /n~I~f~ ^ Return Receipt for Metdwtdise ^ COD ~ <br /> (~(.,~iVtl W ~~ 7. Date of Def e <br /> ..JJ o ' <br />a. <br /> 5. Receivetl By: (Print Name) 8. Addresse 's ass ( my i/requested ~ <br /> end lee is paid) _ <br /> i t. <br />~ 6. Sign e: (Addresse or genQ <br />A <br />tl X <br /> Ps Fomt 3811, ernber tssa Domestic Return Receipt <br />- - _ ` 'c 41f X76 646 <br />Recei ~~Qr,•, (~(~ ~.. <br />CertifPe~'8A'diF~'"""- <br />ND Insurer~q~~o~ rA <br />~~ DD not usriYer <br />tc<o Re~e.~et ! <br /> t m .,1 I <br />T 1 <br />Ct P' <br />•V. <br /> StaN d Z e <br /> osrage <br /> Can Area Fee <br /> Speuai Dairvew Fee <br /> Reavrtmd Dehvary Fea ~~ <br />^ <br /> <br />n <br />u Return Recemt Snawinq <br />ro Whom & Dme Oeiwe~ed <br />Return Receipt Showing to Wnam~ <br />Dale, and Adtlle55eE~9 Atld1e5 <br />5 <br /> <br /> <br />' <br /> iOLAt PoStaye^~I~IF <br />r <br />BFees UL_1 - <br /> <br />' <br />~ Postmark p.(~f4e 0 ~ ~Iy~L+ <br />f [~ .l lJ <br />ivlsion of Iwnerals ~ Geology <br />