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~~ ~ ~ ~ ~ - . e'i . <br />SENDER: ~ _ <br /> <br />• ,Complete it•me t end/or Z tar eddiiionel aervicee. <br />~'Gani I•te items 3, end ba 8~b. .~ " . ~ • <br />: ,~ <br />~ <br />e.2 . <br />.:••• <br />I •8150- Wf6~1 t0'. receive the , <br />e ' <br />following services (for an <br />ektre <br />, <br />. <br />t ' '~ P,rn our dame end eddreeq•on ,tha~?everss.ol this fomr+so, t <br />. r' <br />' <br />TiF <br />T <br />r <br />"I <br />e c <br />'-- <br />~ hat we can . <br />feel: ~ .' (, <br />" ~~': ~.~ <br />. <br />:retQ <br />i <br />e <br />d.to you. -: Y'"'. <br />m4 <br />.. <br />:,r~>'"°..s .=..~ <br />~ A"ttec}i; this }dnn to the Iront.of the,lnmlpiace; or on thibeck h apace r+. r.t <br />1. LJ Ad~ress6e'9 Address <br />..dose not Kermit 'x'.~r : S:. `. ': •. .. ., <br />4• • ~Nfite"Rveturl}Receipt RYques'te'd"on the mailpiace belUw ttiesrtide number. <br />.. <br />T <br />' <br />' <br />2. ^Restricted Delivery <br />he Retum Reeeipt <br />• <br />.Fas will provide you the eipheture of [hero~( aon dalivere <br />~ to antl thgdete of delivery.' - Consult OstmeSter for fee. <br />3. Art+cle Addressed to: 4a. Arti cle Number <br />(v~(z. (Jna~ (Yli((s <br />~ P ~ o x> B9~ <br />, <br />~y''O' ~/~q <br />(~r•y$jl ~t7 V }t(NI~ CO <br />',~ 4b. Se ~ Type <br />^ Registered ^ Insured <br />, <br />~~ ~ ~ <br />'~ r <br />P ~ .Certified ^ COD <br />il ^ Return Receipt for <br />M <br />^ E <br />, <br />• xpress <br />a <br />Merchandise <br />p ,, ~~ ! ~ ~~~ <br />1;~I(12~'J(~2u+ K 7. Da a of Delivery <br />5. Signature (Addressee) 8. Addressee's Address IOnly If requested <br /> and fee is paid) <br />~I nature IAgentl <br />~~ _ . <br />nbti4a-Iy p g6p-~170 $95 <br />~ ~ Certified~Mail Receipt <br />No Insurence Coverage Provided <br />~~ Do not use fo al Mail <br />~-` ~,u Yla (See Reve <br />W Sam a <br />VgNCF r <br />w ~ <br />~ p-i NIUR CA <br />Sveel 8 No. d~ <br />1'le- ~ l ~OB <br />P.O., slate 6 ZIP Cotle <br />~ ie.~t (l 7~ ~ <br />^i~ IWtasa <br />3 Cenilied Fea <br />1V <br />~ Spacial DaLVery Fea <br />_~ <br />0 Restricted Delivery Fee <br />(D <br />~ O Return Receipt snowing <br />(p A to Whom d Dele DBlrvemd <br />1 ~~ Return Recerpl Showinv to Whom, <br />~ Data, 6 Addmsv of Delivery <br />TOTAL ibstage <br />6 Foes <br />PaelmeM or Dale <br />i <br />:~ r ; <br />N <br />a -- <br />