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1~~- <br />Prinf Cleady) B. a[e of Delivery <br />~~~' V I <br />T <br />a <br />r <br />7 <br />J Postage $ • 3~'} ~4n C~ <br />~ <br />^ <br />CeniLetl Fee <br />~. I ~ ((rye <br />VQ SGP <br /> <br />Return Rece~pl Fee <br />/~y~ <br />I Q <br />Y Poslmal•Ip <br />? (Entlorspmenl Regwr¢d) "" O Hem pp <br />211\1 <br />] Restncletl Delrvory Fae / <br />] (Endorsamenl Regwredl _„< <br />u <br />D Name (Please Pr/nr Clearly) (TO be comp/erect by mailer) <br />D 11 ~~^~ <br />...-..-..... u~ ....................................................................... <br />_ Slreel, A~~~J/r~(~N~lo\.;1 or PO Bor NC/o. <br />] CITY, Stale -}a .... l.~~. o ................................................ <br />- ~eawl.looa~ x,51 ~ fSa4 ~'7 <br />Prinf Cleady) ~ Dtle of <br />1 M1 <br /> ^ Agent ~ <br /> <br />~ <br />^ Addressee <br /> <br />r9 _ <br />ass different from Item 1? ^ Yes Posla e <br />9 S <br />' `~ <br />ss dircer t f rr <br />OAK Cq <br />1 livery atltlress below: ^ No M1 <br />~ <br />i <br />i <br />F <br />~• /~ ~ <br />~ ,livery address t <br />I ~ Cen <br />l <br />eo <br />ee <br /> <br />D Return Receipt Fee / <br />sr/ r~ n <br />~ bra <br /> .. (Endorsement Regmretl) < e O <br />N <br />) ! f <br /> p Restricted Delivery Fee <br />(Entlorsemem Regmretl) ~ <br />S <br /> ~ C <br />9N <br /> O Total Poetage 8 Faes ~ ~ ~ 5~ ! <br /> <br />ail ^ Express Mall ~ it ^ Express Mail <br />elurn Receipt for Merchandise Name (Please Prlnr GlearlyJ (TO be completed by mailer) <br />ti Return Receipt for Merchantlist <br />it ^ C.O.D. rn <br />L7K-!~!y-?....I1'~?.~~.~~_ ......................................... ^ C.O.D. <br />ivery7 (Extra Fee) ~ yes ~. Sfreer, Apf. No.; or PO Bor No. ' <br />--- -'-------- rerv. (Extra Feel <br />~~ 5('?~ ~r~ M1 Cll Stale, ZIP+9 <br />117711~~ KV INf~E-A1 Dl-IS <br />- :rr ?.. .. .. . <br />102595-99-M-1TB9 p$ t <br />^ vas <br />~b1 <br />10259599-M-I ]09 <br /> e r e se Pdnt ) B. Date of Delivery ' <br />~ <br /> 9-~ v <br />i <br /> <br />M1 ///III <br />/^ ^ Agent r <br />U / ^ A <br />0 tldressee ~ <br /> <br />O <br />voslage <br />S <br />e C O <br />~`(` <br />B v esa diflaall rrom item ,? ^ Yes v- <br />Nivery address below: ^ No ~ <br />~ Cenilied Fea a '' ~ <<QQ <br />Q' S`%~ <br />~' ? <br /> <br />Rglurn Recei <br />t Fee ] <br />U P(~lii k <br />f <br />L (~ O(~ <br />p <br /> p <br />(Endorsamenl Regmretl) /'~ Q. I~~ ! <br />, <br />\\„ ~ <br />J <br />J Reslncted Delivery Fee <br />(Endorsemem Requcetll ~ <br />~ <br />Oj <br />Q <br />US <br />D <br />f <br />J Total Postage 8 Fees ~ ~ 9 ~- O <br />~i ^ E1[pre~ Mai ~I1 <br />u I ^ Renan t1aF«t rot ~.irsrriar,dt ° <br />1J Name (P/ease Pr/nr Clearly) (TO 62com`p/elad Dy <br />r rrreller) ~ ~ ^ C.O.D. ~ p <br /> <br />r .....................q.~.P .... <br />.-.. <br />p~NO ............. <br />Slre~ Ap(. No.i 1 <br />......---........--.....--......-... <br />F4+~ (E+ha FeP) ^ Yl•S I p - <br /> b <br /> .,, .. <br />Pnslage 8 <br />CeniM1ed Fee ^ I <br />Return Receipt Fee o~ <br />(Endorsamenl Regmretl) / r <br />Resincred Delivery Fee rx <br />(Endorsement Regmretl) <br />Total Poete9e 8 Fees <br />Print Clearty) ~ B. Date of C'•"vet <br /> <br />.............. . <br />N...._.. C_r.._. I <br />T ~S ffiSl G~ ---........ <br />~O <br />I <br />-~~. C IOC'01/ <br />LJ Yes <br />^ No <br />^ Agent <br />^ Atldressc <br />.dress tliHerent Irom item 1? ^ Yes <br />tlelivery address below: ^ No <br />le <br />i Mail ^ Express Mail <br />.retl 3'-sll-neturn Receipt for Merchandis <br />I Mail ^ C.O.D. <br />Delivery? (Exl2 Fee) ^ yes <br />~I~ <br />r ~~'~ PS Form 3811, July 1999 102595~99~M~tTa• <br />