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Ill Illlllllllllllll <br />U <br />o~ <br />c <br />a>, <br />0 <br />r <br />CV <br />r <br />tlf <br />}}~ <br />mod. <br />p~ <br />O <br />• <br /> <br />T [n <br />_. ~ <br />~ Z 192 124 6R7 ~ <br />([~ US Postal Service n <br />~° Receipt for certified Mail o '- <br />No Insurance Coverage Provided. ~ < ~ <br />~ Do t f l t Uonal M 'I Se m e <br />no use or n ems ~ e ve <br />to n <br />ner s ,n. 1. <br />'~aR t( 4~ <br />Post Office, State, 8 ZIP <br />o <br />~ a <br />Posfape s <br />Certified Fee <br />Spedel DelNary Fee <br />Restricted Defiwry Fae <br />Rclum Recdpt Shoring to <br />vJhorn 6 Date Deliwle <br />Reeun ReLeyl ~ (,+O <br />Dale, 6ldtressce <br />TOTAL Poste es S <br />Posanark or D _ <br />W <br />X999 <br />~ <br />1 5 <br />t <br />5p/ <br /> rs <br />) <br /> <br />S)=NDER: I also wish to rep~jve the <br />•C'amDlBle ilem9l enNOr2for eddldonal eenicu. IOIIOWIn SBfVICeb fOr fln <br />' • • Complete iten• 3, b, antl 4b. 9 <br />• Pnnt youyur name end address on me reverse of tnfs brrn eo met rr ran return mle e%tra }9e): <br />~ ~ • Adech the form to me front of me meilplew, or on me bark If spew does not 1. ^ Addressee's Address <br />ppermit. <br />• Wnta 'Karam Rewlpr Requested'on me meilpiew Below the article numwr. 2. ^ Restdcted DBIiVery <br />• • The Rehm Receipt w1U show to whom dte anitle was deave,ed end Vw data <br />" ~ delivered. Consult postmaster for lee. g <br />rd 3. Article Addressed lo: II // 4a. Article Number <br />~ter~ ~te1s Mien Co Z 19~ 102} (o0T7' <br />~~ `~j '' 11 q i I 4b. Service Type - <br />lG ~~-I I `l ^ Registered ^ Certified a <br />C ~ S r ~ ^ Express Mail ^^Insured ~ <br />O {~ V~CC ~ ^ Return Receipt for MerMetfdise ^ COD ~ <br />7. Date of Delivery <br />5. Received By: (Print Name) 8. Addres ress requested Y <br />end ! iy~, <br />6. Signatur ~ ddr a or Agent) '\ <br />ii X <br />a <br />PS Form 3811, December 1994 wuasao-laaxze urn Receipt <br />_• - -- <br />' naa~_-a ~..... - _ .. - l <br />