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<br /> <br /> <br />r Resteae s ~yER CO CO <br />"' <br />..D tee ~ a~ y~ <br />N <br />„~ Relum Receipt Fee <br />(ErtdcrserneM Hequhed) ` ~ I N'eW a <br />0 <br />~ <br />o <br />Restrkled DalNery Fee <br />tFndareementReprhed) c~- <br />d ~~ .Ci` <br />r <br />°~ <br /> ,_ ~-~r, <br />p Tattl troempe 8 Fsee ~ ~-- ~ <br />~ i~ <br />7 . <br />D"' <br />'~ S t To <br />~J r, <br />$ ~It <br />~~GVt <br />Y <br />~ t~" <br />~ (,m ~rlnk tz~/~ <br />lt4 <br />~ <br /> <br />~ <br />0 _ <br />_ <br />._. <br />----_.. <br />---~------------------ <br />..__--- --- -- <br />- <br />Street. AOt. No.; art t <br />a Po Box Na `~,TI~ iJ ~.~ n ~_.___./ <br />M1 CIry, Slete,9W4 I 1/'t.(yv <br />l• (Q 7~ ~/7 <br /> rr <br />:rr <br /> <br />^ Complete items 1, 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 the mailpiece, <br />or on the front if space permits. <br />1. Article Adtlressed to: <br />~r'ttrv~k ~c,rrns <br />~SqU T~r;H-u.KH bn've <br />~GS3~- <br />A. Signature <br />X / u ~i~ <br />Agent <br />8. Received by (Printed Name) l~ C. Data of Delivery <br />J(' ~7AZ <br />D. Is delivery adtlress different from item 7? ^ Ves <br />If YES, enter delivery adtlress below: ^ No <br />s <br />i <br />3. Service Type <br />Certified Mail ^ 6cpress Mail <br />^ Registered ^ Return Receipt for Merchantlise <br />^ Insured Mail ^ C.O.D. `~` <br />4. Restricted Delivery? (Extra Fee) ^ Yes 1 <br />z. ArticleNUmber 7001 194 ~~p6 6379 3886 i <br />(transfer from service label) <br />PS form 3811, August 2001 Domestic Retum Receipt ID25es-ol-M-oaer <br />