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P 436 78~~?~ <br />_ (~~ <br />US Postal Service <br />Receipt for Ce~t~~~ <br />No Insurance Coverage Provided. <br />. {... r..{..melinnnl lloil ~CGO rOVwTF) rl <br />v <br />°o <br />C <br />a <br />C <br />G <br />0 <br />SenttoG _ vlkCC~ (_,(i[Qy ~ <br />.J~ C <br />57re Number.~C ~~ <br />Pa Olfice, S te. 8 ZIP e / <br />Postage $ ~ j L <br />Certlfied Fee / ~ O <br />Spedal Delvery Fea <br />Res~dged Delivery Fee <br />Retum Receipt Stewing to <br />Whom 8 Dete Delivered D <br />Realm Retepl <br />Daro, 6 Pdd'essee'x q <br />TDTAL Posiaga s S o <br />' PosMark ar DatpO W N N _~ <br />v~ ~ <br />C <br />m SENDER: <br /> <br />9 <br />•Camplete Items 1 and/or 21or edditlorve services. I also wish to receive the <br />e .Complete items 3, 4e, end ae. following services (for an <br />m <br />~ •Pdm your name eM address on the reveres of this lartn w Nel we mn Tatum this Bxtfa fee): <br /> <br />~ urd to you. <br />•Adach Ihia loan to the hrxrt d the meilpiece, or on the bedr it space does ncl <br />7, ^ Addressee'S Address <br />~ pemtit. <br />•Wme'Retum Receipt RequrMed'an tM mailpierr odlow the anicle number <br />2. ^ RBStdded Delivery <br /> .The Relum Receipt will chow to whom the artlge was delivee0 and the dale <br />~ deavered. Consult postmaster for fee. <br />v 3. Artide Addressed to: 4a. Artlcle Number <br /> <br /> <br />o ~L~t « ~~ co ~,~ ~ y,,N <br />I 4b. Service Type ~' <br />u ^ Registered ^ Certlfled <br /> f~Q ~o ~ (s-7O <br />^ Express Meil r ^ Insured <br />c <br /> <br />n D G I ~`3 ~ <br />~ <br />( <br />' O <br />^ Retum Rttceipt for Melchendise ^ COD e <br /> (LC,t <br />Q Sl_ <br />. 7. Date of Delivery <br /> _ I 'o <br />r <br /> 5. Received ey: (Print Name) 8. Addressee's Address (Only i/requested ~ <br /> end lee is peidJ <br />g 6. SignaN e: (Addresses or gerd) <br />r 0~(1 4/ <br />~r <br />e <br />PS orm 3811, December 1994 1025959] B-0r]9 <br />