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Rem%v <br />~~y ed <br />?~Zn 4 <br />Oit,/s/OofngcF 0 <br />o,A.;~4 re/d <br />/Y/_ ~ ,5 O,c;~ <br />aOOy o ~ CEO%y <br />63 <br /> .~ <br />ti ~ <br /> <br />u- •. <br /> R11 <br />o <br />m ~ , <br />® ~a ® p <br />II6i1 ! ~ f <br />69 <br /> . <br />"' <br /> <br />rv Ros18e9 a 0.37 iR1 - <br />O <br />~ <br />o cedmed Fee <br />z.3o <br />~P <br />O <br />C <br />T p <br />o <br />~ <br />(Engorgement Required) <br />1.75 <br />a n~ <br />q.~. <br />J~ <br />yy <br />F',.9 <br />O <br /> <br />O <br />.d <br />RBaWcted OelNery Fee <br />(EMOigement Required) <br />e v <br />RJ <br />~' total Postage a Fees $ 4.42 10/ P S <br />m <br />t7 nr To <br />uWt'~Ec.srxsgsoFu~+ ~N <br />t` SdeeC:iyiWd.F• <br />TRUST - $o • t1*e- ~ •~e <br /> or Ppaprryo <br /> city, smie; zfw"i P O BOX 737 <br /> IGNAC(Q CO 81 137 <br />d <br />S SENDER: <br />Complete Hems 1 anNO! 2 for additional Services. I also wish to receive the <br />a .complete items a, 4a, ana ab. following services (for an <br />m • Print your name and address on the reverse of this form so that we can return this extra fee <br />~ <br /> <br />j card to you. <br />eAttach this Porm to the front at Me mailpiece, or on Me back H space does not <br />~. ^ Addressee's Address d <br /> <br />q, . Whte11Retum Recei t R uestetl' an the mailpiece below t <br />p eq he adicle number. <br />2. ^ Restdcted Delivery d <br />y <br />r eThe Return Receipt will show to whom the snide was delivered antl the date ii <br />~ delivered. Consult postrnaster for tee. . <br /> <br />0 ~ <br />v 3. Article Adtlressed to: 4a. ANcle Number - m <br />m JNITED STATES OF AMERICA IN ~~` 3 .~?GCJ Ov7 ~71J c <br />E TRUST - $o • V'}'c ~'r;1,c 4b. Service Type - <br /> <br />` ° <br />d <br />u° P O BOX 737 ~~ t0 <br />CO ~ .Certified <br />^ Registered rn <br />w IGNAC[O, C0 81137 , <br />^ Express Mail <br />~~;j ln <br />~ured w <br />c t <br />/ <br />^ Return Reaeigt fo <br />rchandse ^ dD <br />0 . <br />7. Date of Deliveryr 1 ' - < t f <br /> t o. a-O o r <br /> <br /> 5. Received By: (Pont Name) 8. Addressee's Addre n egtrgsted <br />• ~ <br /> .Q. ~ £~ <br />S and /ee is paid) <br />\U,••SPS~' _ <br /> . F <br /> 6. Signatu e' (Adtlressee or Age ) <br />' X 0 <br />_ <br />N <br />Ps Form 3 <br />1, December tssa <br />Domestic Return Receipt <br />