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R t SLNUEN: Comple le irema 1, 3, and J. <br />Add your addreea In the "RETURN TO" apace on <br />~ re~e ne <br />I. The fnlnw•inl; service is resluestrd (check onr). ~~[[~~ <br />Shaw m whom and dale debeered ........L.Z< <br />$hosv m whom, dale, and address o! delivcry.._P <br />RI:Sl'RICTI~.D DELIVERI' <br />Slrow to whom and dale delivered. .. ...._q <br />^ REST'RICTED DELIVERY. <br />Slsoss• to whom, dale, and address of drlivery.3- <br />(CONSLILT POSTMASTER FOR FEES) <br />3. ARTICLE ApDRE55ED J~O: <br />m4~,dLnn4 LSJj'-f'p.. <br />r')')OOPL ~Qq~~.+ay..~alf~ <br />c 3Qer,~ Cp Qoao,3 <br />a <br />Z ]. ARTICLE DESCRIPTION: <br />m REGISTERED N0. CERTIFIED N0. INSURED N0. <br />m <br />9yg9z3 <br />a I IAlwaya obnin upnttun of adtlmrea or spent) <br />D_ 1 have tecc ived the article described above. <br />~ SICNAT <br />Addressee q,AulllorizeJ agent <br />n l <br />° l - .~ ,. ~ <br />.. ~ <br />~ DATE Or DELIVERY ' <br />m `~' r <br />n 5. ADDRESS (Cpmpl.le only it raqu• rid , ~ / <br />O ~~~ n <br />m ~ <br />a, 3K'~ <br />6. UNABLE TO DELIVER BECAUSE: ~r Cl 'S <br />~ IAIs. <br />3 7 <br />D ~ <br />3 <br />~_ <br />' s <br />I <br />i <br />I <br />p e. r. na-ur <br />.. ... .. I <br /> ~ SENDER: Comple le ilema I, 3, and J. <br /> Add your addreaa In the "RETURN TO" apace on <br />rCV[rQ. <br /> I. The follasvin,l service is resluef led (check one). <br /> Show to wham and date drllvrred. ....... { <br /> Show In whom, dale, and address of delivCfy ~-P <br /> RESTRICTED DELIVERY <br /> Show to whom and dale delivered... .......Tq <br /> RESTRICTED DELIVERY. <br /> Show to whom, dale, and address o! delivrry.3_ <br /> (CONSULT POSTMASTER FOR <br />FEES) <br /> nn~~ <br />/~ <br />i.LORfJC~4nd Es~. /~1~( l~f1C~2~'2~CK~ <br />L <br />y <br /> Pd • ~x a4 9 <br /> Lo~e.fand <br />Co xar3~ <br />i , <br />' 3. ARTICLE DESCRIPTION: ' <br />I REGISTERED N0. CERTIFIED NO. INSURED NO. <br /> <br />i 9~1a~9~S~ <br />~ 'I IAlwaya obbin aipnatura al addmaea or agent) <br /> .I have received the article described above. <br /> SIGNATURE ^ Add reisec ^ ulhonzed agent <br /> <br />J <br />F _4 <br />~ <br /> . <br />DATE OE DE ER <br />P, <br />O <br />{`MARK <br />p . <br />1 <br />U ( <br /> ~ <br />M1J <br />D 5. ADDRESS (Cemp4b only it nqun •tll a. <br />° ~ 1979 <br />n <br />y <br /> 6. UNABLE TO DELIVER BELAUSE~ -CL" RK'S <br />r" <br />O INITIALS <br />3 <br />D <br />r <br />a} aro, rarrrrr.rn <br /> <br />• <br />