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o- SENDER: <br /> <br />Comdata xtan. 1 •nNa Z f« •ddtiorw •snic••. I also wish to receive the <br />e .Comdata came 3, aa, and tb. 1oNowinp services (for an <br />v <br />~ • Prim your name and edtlreas on the reveres of this loan so that we can mum this Bldre (BB): <br /> <br />j card to you. <br />•Aaech thin form to 1M from of tM meildece, or on tM oarx if apace dose not <br />it <br />7 , ^ Addressee's Address <br />~ <br />e penr <br />. <br />•Wele'ReNm Repaipf Requtbfed' on the mallpiece Wow ma sniGe number. <br />2. ^ Restricted De1tVBry Y <br />rX <br /> •The Retum Receid will allow to whom the anltle was tlelivrlred antl the Sale <br />~ <br />0 Delivered. Consult postrnester for fee. <br />'Q 3. Artlecle Addressed to: <br />/`o ~ 4a. Article Num/bar u <br />~tP U J~~ <br />c <br />n <br /> <br />u d ' '^^-- <br /> <br />~~~ ,~ ~ 4b. ervice Type <br /> <br />^ Registered ~ Certified <br />0 <br /> <br />w <br /> nn ^ Express Mail Insured <br /> <br />E <br />C c <br />a <br /> ~~ <br />~/~S <br />C `~J ^ Retum Receipt to <br />~ <br />D <br /> a <br />. 7. Date of Delive <br />N <br /> ~ <br />y <br />N 'o <br />~ <br /> int Name) 8. Addressee's ss (O ' req esf d ~ <br /> end !ee is poi = <br /> <br />~ 6. SXnatur d ssee orAgen~~1/ r / I \ <br />PS Form $811, Decemb 1994 102595-9]~B-0I]9 <br />_ P 436 783 517 s <br />~ ~ <br />US Postal Service <br />Receipt for Certified Mai , <br />No Insurance Coverage Provided. ~Y <br />u <br />C <br />0 <br />C <br />i <br />L <br />t <br />Do not use for Intemafional Mail See re <br />a <br />S~ <br /> <br />SI Eer / y <br />u( <br />~, .. s e. Z1P Codg/) <br />(~ ~iasa <br /> <br />Postsga a a~ <br />- <br />CeNfisdFe9 /~~ , <br />~ <br />Spedal Delivery Fee Y <br />Restricted Delivery Fee <br />' Relum Rated Show"vq to ~J <br />-- <br />Whom d Date Delivery ii <br />F Rehm RettVl Slo•Tq mlNhoin; i <br />Dare, d MNasee's Adheaf ' <br /> <br />i TOTAL Postage A Fees <br />~-, i <br /> r <br />) Poetrnazk or Dal0 - ~ i >' <br />) ~ <br />/ / <br />, <br />IN' / <br />( <br />j <br />J <br />7 <br />7 <br />7 <br />R <br />