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" S`EN~~F~ <br /> •canip.le h•e° t .na« z t« aadn«w •«vkaa. t also wisp to receive the <br />° ~ <br />~ fdlowing services (for an <br />g • a~y u~ na <br />ine e~w eaa~ <br />e on me levane of tnie roan eo that we can velum we extra fee,: <br /> <br />certl le yoa. 8 <br />j •MBM ebs roan to the hom of the mellpiece, or an the bark if apace do69 not t <br />O Addressee's Address <br /> <br />E <br />w«+t~ , Z <br /> <br />$ •Wdte'ReNm Recei R neared' on the mail ace below the article number. <br />q <br />M <br />d <br />2. O Restricted Delivery ° <br />y <br /> •The Retum Recei <br />WII, <br />ow to wlam the erl <br />e was dalivaretl entl the date <br />e tleiivr.tl. Consult postmaster for fee ~ <br />o t¢ <br />p 3. Article Addressed to: 4a. Article Number X <br />n ~l~ ~ TeZAJL ~ 3 8~ g E <br />E /1~ 4b. Service Type ~ <br />°u : W ~~ ~ Q U~ rt Q-S ^ Registered ^ Certified <br />t~ T© ~ ~ / 5 ~ ^ Express Mail ^ Insured <br />~Tn NOn n ~ l ~ . g~~~a ^ RetumReceiptforMemlisn6se ^ COD S <br />LU t l.. r 7. Date of Delive ^ ,\ ~ <br />~( uU O <br />T <br />5. Received By; (Pdnt Name) 8. Adtlressea's Add 0ss (OMy it requestetl ~ <br />end lee is paid) i <br />r <br />6. Sign re: (Addresseeer g nt) <br />a°. X <br />• <br />PS Form 811. December ~ 4 ~ ,ozses-sr-a-0~r9 Domestic Retum Receipt <br />