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o SENDER: <br />L •COmplete items 1 enNOr 21or etltlilfonel eervicee. I also wish t0 reCBIVe Vla <br />er •Complele items 3, 4a, and 4D. }OIIOWIng SBrVIC95 (}Or Lin <br />m •Pdm your name and address on the reverse of this form so that we can return this exits tea): <br /> <br />j <br />r card to you. <br />• Attach this form l0 the horn of the mailpiece, or on th0 back it space does noI <br />~ , ^ gddressee's Address m <br />~ <br />` <br />d permit. <br />• Wdte'Retum Receipt Repuesretl'on the mailpiece below the edicts numaer. <br />2. ^ RBStricted D01iVery ~ <br />y , <br />$ • The Return geceipt will show to whom the snide was delivered and the dale a <br />~ tlelrverea. , Consult postmaster for lee. m <br />0 <br />a rgcl <br />e A <br />re <br />d <br />d <br />d <br />sse <br />t <br />o: 4a. Artcle Numbe <br />r u <br />n 1'_ <br />_ <br />- <br />- <br />n <br />1 <br />, <br />~I <br />ea <br />C~ WI 4~J ~ <br />~ f'lf CJ ~ C~ <br />O <br />I r ~-~U ~ <br />u ~ <br />c <br />ht~~il~ I I _ ~ ~ ~~ ~ r nc~ ~ f p 4b. Service Type m <br />~ <br />y J <br />~ ~Y ~~pe <br />~ <br />'~ ^ Registered ^ Certified ~ <br />v <br />i ~ <br />- ^ Express Mail ^ Insured c <br />W <br />o q~ 'c <br />} CD ciJ ~ t~ (rQ ~Y <br />~..CZ-1CLe~~ <br />atum Receipt for Memhandise ^ COD •r <br /> , of Delive <br />ry ~ . <br />~ ~ H~ C ~ . <br /> 5. Received By: (Print Name) p 8. ssee's Address (Only i! requested ~ <br />w a. <br />199a nd ee is paid/ t <br /> 6 ~R <br />~ 6. SXnat~ (AdCre e <br />m <br />PS Forth 3811, December 1994 <br />peC. ~C <br />~_ Z 191_~i~b; 5 5 4`~bs 7 <br />~'~ US Postal Service <br />J. Receipt for Certified Mail <br />c.9 No Insurance Coverage Provided. <br />;j Do not use for Intemadonel Mail See reverse <br />VP to tJA Wt1 O/1 <br />cU Strael8 Nu r <br />~ 70b rr ~e. <br />~ asl Olfia. Stele. 6 LP Code ~SGa ~S <br />7 <br />Postage S / D <br />N Certified Fee <br />r <br />!.-1 Spedal Delivery Fee t _ -_ <br />v fiesfdded Delivery Fee; ', <br />CD <br />N <br /><~ getum Receipt Show%rg9D <br />(,D._~q Whom 8 Date Da <br />CF DaCe,6~ s <br />C~O TOTAL Postage d s <br />Pnstrnerk Or Data <br />1 <br />