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,yo Re~'~ed <br />o;,,~sia u,~, 2`~~004 <br />n~f ~` wais o~~e <br />~ BOO ~ G~0%n <br />S! ~6 ~~~ <br />3 <br />CERTIFIED MAIL,M RECEIF <br />(Domestic Mail Only; No /nsurance Cavera~ <br />cE ~ I I sl <br />N , <br />~-I Pastape s 0.37 ITti <br /> <br />M1 (t7 <br />9Z <br />CemBed Fee <br />° 2.3D <br />~ Retum Redept Fee <br />(Entlorsament Required) <br />I.75 <br />° Restrkted Delhrery Fee <br />.~ (Endoreemem Repaired) <br />r <br />4 <br />f1J Total Poarege 8 Foes $ 4.42 I0~213/04 <br />m q~ - _.- <br />rte`- S6ear,Ay~ o.; c2 (Q~~~~-_~ pyy . <br />1`i~..C7sYi - . <br />- <br />arPOearNO. $'~ ~` <br />:rt <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 />,. 8~ A~'r''~I-/~y <br />~ja~~( r'V~f l2 <br />~~., Go 8t,3~3 <br />(Please Print Clearly) B: Date of Delivery <br />C. Signature <br />/~/~~ Q~ t Q.Agent <br />X f Yl 13~e..r! Y / I a.N?h I--I ean.e«m <br />D. Is delivery address different frb/n dam 1? ^ Yes <br />If YES, enter delivery atldress below: ^ No <br />3. Service Type <br />^ Certifed Mail ^ Express Mail <br />^ Registered ^ Return Receipt for Merchantlise <br />^ Insured Mail ^ C.O.D. <br />4. Restricted Delivery? (F_xtra Fee) ^ Yes <br />2. Article Number (Copy Irom service label) <br />7~~ ~D tx~7 ~2-o v ~9 <br />PS Farm 3811, July 1999 Domestic Return Receipt 102595-99-M-1]89 <br />