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o SENDER: <br />9 Complete items 1 entl/or Z far additional eervicee. <br />• • Complete items 3, end 4a 8 b. <br />p • Print your name end atldreee on the reverts a/ this form so that we ten <br />`m return INe certl to you. <br />• Attach this /orm to the front of the meilpiece, or on the~eck it apace <br />does not permit. <br />• Write"Return Receipt Requactetl"on the msilpieu belosy."lhaartic umbe <br />• The Return Receipt will chow to whpmthe article weedeliverad en~hetlet <br />C delivered. <br />a 3. Article Addressed to: 4e. AI <br />e <br />$ 5o~-rcr~se~~trt~ co. <br />E 4b. S[ <br />1 also wish to receive the <br />following services (for an extra St <br />feel: Z <br />1. ^ Addressee's Address y° <br />2. ^ Restricted Delivery •e <br />Consult postmaster for fee. o <br />~.le Number <br />~ SoS ~q3 E <br />S <br />rte fivpe <br />~d. t,~0a- ~~- ^ Registered ^ Insured <br />a <br />v_~ 5 0~ erS6,~ r~0 ~j Certified ^ COD .„ <br />T $~tt'3y ^ Express Meil ^ Return Receipt for ~ <br />Merchandise <br />7. De of Delivery w <br />_ 7 <br />O <br />IAddresseel 8. Addressee's A dress (Only if requested Y <br />end fee is paid) m <br />L <br />IA F <br />i• ec 1 1 r os...o:rt IC' <br />e`'--- - - -°- ~ --- - ° <br />SPec. SSS <br />P 31, 7 817 8 p'~e9 ~~ <br />Receipt for ~~ ~8 <br />Certified Mail ~~'"'~ <br />No Insurance Coverage Provided <br />w.~•:<w~. Do not use for International Mail <br />ISee Reversal <br />m <br />"r <br />J <br />~0 <br />:7 <br />C <br />LL <br />N <br />a <br />Sem ~o r <br />SO <br />+ <br />/ Co <br />/Q <br />/ <br />SC . <br />rn Ctl <br />Areei ono No ~ <br />O: O _ <br />S W <br />Scale entl DP Code <br />R O (n <br />. <br />I S e r ~'1- Co ~r ~ <br />m <br />Postage <br />_ <br />Cen~lietl Fee ~ <br />Speaai Oclrve~y Fee <br /> <br />nesv¢ieo Den.ew Fee N <br />9emrn Recemi Sh nng <br />~ (J1 <br />m whom B Dare ~ ~ 0 <br />R n t ~ <br />Remm <br />ace~pi f 9 pn._ <br />~ ~ <br />Dme, a~a ntla~ ~~ s l ~ <br />iOigF Pos~age ~ ~ ~ <br />C Fees ..~ <br />Postmark of Dale t, r <br /> <br /> <br /> N <br /> <br />