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3 SENDER: I also wish to receive the <br />• Complete items 1 end/or 2 for edtli[ional services. <br />m • Complete items 3, and 4e 6 b. following aerviCea Ifer an extra <br />~ • Print your name and address on the reverse of this loan so that we can feel: <br />j return this card [o you. <br />m • Attach this form to the Iront oI the mailprece. or on the back it spate 1. ^ Addressee's Address <br />~ does not permit. <br />V Write"Return Receipt Requested"onthe meilpiece below the article number. 2. ^ Res[riCted Delivery <br />• The Retum Receipt will show to whom the article was delivered and the date <br />G aehvered. Consult os[master for fee. <br />v 3.II ,,A~rticle Addressed to: Article Number / <br />a /-, <br />iOC~~C„-,~-I~ ~Qr 1 v~•{-1 / 4b. Service Ty[ <br />u ~ r 1I1''..1x.-.. W t ~ ~f ,^~~Registered <br />y I ~ • ~X 4 W L7 Certified <br />~ MO(/'~~ v 15~ CO p (~(~[ I ^ ExPce51 Mail <br />~ _ , T 7. Date of Delive~u~ 19 1995 <br />a <br />~ 5. ignature (Addressee) 8. Addressee's Address (Only if reque <br />and fee is paid) <br />H <br />~ 6. Signature IAgentl <br />0 <br />n PS Form 11, December 1991 vu.s. GP0: 1au~-asz~7t~ p( <br />P 296 ,6U~ ;472 <br />Receipt for <br />Certified Mail <br />No In~~ysu``ra~~nce Cov ra ov ed <br />~"~ "'.u:...cr DOJO i I it <br />0 ~ ISe a rs <br /> ~~ io ~ "- <br />1~~ Y ids <br /> 4 <br /> <br />a, P,G Siaie and aiP tle <br />M lf' <br />0 <br />811 <br />? Postage <br />C <br />N <br />Q Cend~etl Fee 1(~ FL <br />7 <br /> <br />~ <br />v SDenai Deliver ~o9Y <br />c eo <br /> <br />E Reslncletl Delivery Fee 1a <br />~ M~~e <br /> Pe~mn Wowing <br /> ~o WM1OM$ Daie Deiive~ec <br /> ReWrn Receipt Sno venom <br /> , <br />Dille, an0 POtlr pe ~ • <br /> i°TAL Pos e <br /> 8 Fees ~ <br /> Postmai or a~^ q / <br />W` <br />Q <br /> '~ ~ s <br />~ <br /> 0~ <br /> / <br />/ <br /> <br />^ Insured <br />^ COD <br />^ Return Receipt for <br />RETURN RECEIPT <br />V <br />.~ <br />to <br />6 <br />.~ <br />0 <br />c <br />e <br />m <br />.„ <br />w <br />0 <br />c <br />to <br />t <br />t- <br />