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<br /> ,~ <br />455 <br />7~~ <br />- <br />' P21 <br />FOR CERTIFIED MAIL <br />RECEIPT <br />OVIDED- <br />NO INSURANCE COVERAGE PR <br />Ofl INTERNATIONAL MRIL <br />- <br />NOT f <br />(See Reverse) ~ <br />SENT 10 <br />y) 4l/J <br />V' / ~ r <br />RI Ei ANDr~ / <br />;STATE AND ZIP CODS G~~JS <br />C ~7 /l J <br /> <br />I <br />. J <br />4. ~`~ <br /> <br />- <br />PO'i rRGE _ - - -- rr <br />yr <br /> <br />CERTIFIED fEE - __ <br />--- C <br />_ <br />9 <br />r <br />' °1.. SPEGA•L DELIV ERY _ <br />r ~ <br /> <br />RESTRICTED DELIVERY _ _ __ <br />W ~ <br />a1 <br />Q~ 6 <br />p~ W sHnw lDn~uan ANn ~ J <br />DAnoumEVeo <br />" <br />y - <br />~~ <br />_ <br />~ w $NDW rD WNOM. JPIE r <br />,n ~ y AND ADDRFS$OF <br />~ <br />_ <br />~ OR NF Rf _ <br />g i <br />O w $HDW ID WHOM AND DAIE C <br />YERIO WiIH PEAPiCR <br /> <br /> <br />~ <br />MU <br />i c ¢ DFUVCRr - <br />~ ~ ° SHDa ID WHDN DALE aND r <br />C' A[IDPE55 DF DEUVFPY WIIN y <br />G <br />m PESFWG DOELIVEPY y <br />,, ~ s / SS <br />', = TOTAL PO AQEfL c <br /> <br />~ <br />- <br />r- pOSTM AK D~F~T <br />~ <br />a. ~ <br />3 ~ <br />~6 m <br />~ <br />F <br />~ <br />l <br />i •E A ~A 190^ <br />) <br />C <br />c <br />-~;~, ~r~ - <br />LL \ s <br />, <br />U~ ~ <br />" <br />~ <br />r <br />a <br />-^ <br />M <br />• SENDEq;Complete items 1, 2, 3, end d. - <br />Add yWr addtesv to UIe "RETURN TO" space <br />an reverse. <br />(CONSULT pOSTYAS~ER FOiI FEES) <br />s.~7h following urvitt u requested (checJL one). <br />Show to whom end dak delive[ed .................... _.C <br />^ Show to whom, date, and address of delivery.. .mot <br />x.~RESTRIC'I'ED DELIVERY ._4 <br />(rer rorn'<[ee arri~eryJa i1 ~Mrgee H aeerbn ro <br />the rnurn rerript Jar.) <br />TOTAL ~._ <br />A AMI/GLE )AOORGSSEO TO: <br />O <br />N'F' <br />(,~ <br />~-s-' ~ <br />~ So ~ <br />~ 3 <br />\I. T^YPE OF SERVICE: ARTICLE NUMBER <br />1L_IAE019TFAED ~ W REO <br />cEAnt>EB ^ coo <br />^QPAESS NAL <br />/ ~/~i'cS"F <br />)AMeye oMeln elpnellre of eddra»ee or eyer[t) <br />ebov <br />I have received the uncle deuribed <br />,,. <br />TURE ^ Addrenee Id"AUthorized agent <br />SI~iN <br />A <br />-~ <br />~•(JE/ <br />r~ ~ <br />s' OIITE OP POSIYAPN <br />._ <br />aAnoNESSEtaADOAF~{o.4V~vr=M ~ <br />~ <br />r <br />~ <br /> . <br />.Jti ~.~, :. <br /> ~.;.. <br />f. UNABIE i0 KI IYEA BECAUSE MP <br />lOU E7/ ' <br />h F <br /> ~ <br />r <br /> <br /> <br />