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A <br />• Goeghu ium~ t ellefor 21a watifYHt s.rvieo. I oleo wisfi to receive the <br />• CeeYftae iutrw 3 end p ~ a gttowinp servaee (for en exta <br />te®7 blkrw oo tls revewe 0l ttfe raroaRie a.. an ~; <br />vee. <br />a r AIU4tlUGe tprmao du (rant of the melprcr, or on the bock it rpeu 1. ^ Addressee's Address <br />doarladpRdm"K . <br />• Wrifb°rTetWriRetuy'CttegwliW"011tH meF~riCCetletOwfMnn <br />1aeRittrmRxrpcwieet+pW>o whom ttp erficre w~sdeivnW t <br />CQ •hyn. _ <br />3, ~nicte Addressed to: <br />~------- <br />BENNIE E AND THELMA KOBILAN <br />w 4184 COUNTY LANE 725 <br />OLNEY SPRINGS CO 81062 <br />°a <br />_ ~ 7'~ f. <br />5. Signature (Addressea~ <br />6. Stgnature IAgentl <br />¢ Pf: lllpat 4, December 7997 4 Y.S.G.D.O.: 1092-30; <br />6 <br />i <br />Z <br />t/~i <br />e <br />t d~t 2. ^ Restricted Dalivbry •e <br />th <br />i <br /> COnsutY DOStme3(Qr fQr fee. ~ <br />4s. Article Number <br />P1'~g If~S~ <br />~ <br />Ab. Service Type ~ <br />^ Registered Q Insureo - <br /> <br />Certified .~{' ^ COD a <br />,~ <br />Express MaA" ^ Recum Receipt for ~ <br />and fee is paid) <br /> <br />P 179 ~~6C 789 ~~/ <br />Re glpt fo d <br />Cep ail 3 ~'(~ <br />- No Insurance Coverage Provi ed <br />r» r~uw~ Do not use for International Mail <br />BENNIE E AND THELMA KOBILAN <br />4184 COUNTY LANE 725 <br />OLNEY SPRINGS CO 81062 <br />U <br />y <br />t. <br />Q~ <br />.~ <br />\cV <br />C <br />QL <br />~ll <br />9 <br />Cf7 <br /> <br />i <br />P 0 Save a^0 LP Cade r <br />Postage h <br />9 <br />Ce•t~~red Fee ' <br />SPkC~a D21.ve~y FPe r.. <br />~ <br />+ <br />~ <br />Pes~¢iea De..ye~y r s,Z ^ <br />{ <br />- <br />,r~ . <br />aew~n aereiP~ 5~ w <br />,o whom s oe~e ~•~a <br />Pemrn Aeoe.Pi 5~ w ~ <br />~ <br />Daie. antl AOaress <br />s ~e <br />i0*AL Povage <br />$ Fees <br />Poslmad of Dale <br />'o <br />c <br />nl <br />!~ <br /> <br />