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III lllllllllllllll! <br />9gg <br />m SENDER: I also wish to receive the <br />• Complete items land/or 2 for atldllional services following services (tor an <br />N • Complete items 3, 4a. antl 4b. <br />• Pnnl your name and atldress on the reverse of this Corm so That we can return Ihis <br />extra tee): <br />cartl to you. <br />• Atlach Ihis loan to the lronl of the mailpiece, or on the back ~I space do¢s opt <br />1. ^ Addressee's Address ~ <br />. Wri a I"Re/um Receipt Requesled'on the mailpiece oelow the article number. 2. ^ ReslrlCted DBlivery N <br />• ine Rehm Rernipl xvll show to whom the article was deliveretl and the tlale <br />delrveretl COnsull ostmaster far fee. <br />P <br />d <br />5 3. Adicle Addressed to: 4a. Article Nu her u <br />~ ~// // J 6J ~ ~`-' <br />Flo a5 S . T~.~u., ~ <br />5. Received$y: (Pont Name) <br />m 6. Si tl/e: (Addressee ar <br />0 <br />T <br />p ~~~~ X85 S4~ <br />.Service Type ~/ <br />^ Registered .la Certilied 3 <br />¢ . <br />^ Express Mail ^ Insured ~' <br />^ Return Receipt for Merchandise ^ COD ~ <br />7. Date of Delivery $ <br /> O ' <br />8. Addressee's Address (Only it requested Y <br />and !ee is paid) ~ <br />t <br />t- <br />m PSvF~mS 3811, December/~~-" 102595-9B-e-0229 <br />