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• SENDER: Complete items 1 end 2 when adtli[ionel services sro desired, end complete items 3 and 4. <br />Put your address in the "RETURN TO" space on the reverse side. Failure to do this will prevent [his <br />card Trom belnB roturned to you. The return reesi t fee will rovide ou the name of the arson <br />d livered to and the dace of dative .For edditione fees t e fol owing aervicea ere available, Consult <br />postmafttr or eee en c eck ox eel for additional service(s) requested, <br />1. ^ Show to whom delivered, date, and addressee's address. ~. ^ Restricted Delivery. <br />3. Article Addresaedto: 4. Article Number <br />. <br />~ I 4 D a c~ <br />5 <br />~ <br />~)}(/ - ~ - ' <br />11 <br />', ~ ~ f/4S1 L~.NL~ ~ , <br />~ Type of Service: <br />eglrtered ^ Insured <br />. <br />T <br />~"' ertifiad ^ COD <br />/ <br />l <br />~ Expren Mall <br />~ ~~ <br />1~~~ ~ ~~~ r~ cv~ ~ ~ <br />1 <br />"~-c~rrw,J~'(i / Always obtain aignaturc of addressee or <br />•~ ~ agent end DATE DELIVERED. <br />Sig Lure - A ee <br />r 8. Addrecs s L 1' iJ <br />rcqucs ia'/ <br />' <br />6. Si ne ro <br />gent _ ~ <br />X ~ <br />•j ~Iv~ <br />^i. 1, <br />7. Date of D livery ;-i.~ <br />(. ~ ! !• <br />C <br />I'S Form 3i111,~'eb. 1984 <br />DOME~A'TZ TiETURN RECEIPT <br />P 168 480 026 <br />a <br />4 <br />m <br />m <br />ti <br />a <br />C! <br />al <br />m <br />a <br />LL <br />0 <br />E <br />`O <br />LL <br />r1/ <br />d <br />RECEIPT FDA CEAT:FIED @°AIL <br />NO INSURANCE COVERAGE PROVIDED <br />NUI hUR INIhHNAIIUNAL MAIL <br />(See Reverse) ~ - 153 ~' <br />~- <br />se t to -,-+ <br />J <br /> <br />StreYr~nd Nq. - _ <br />~ <br />~ <br />l..J ~.. <br /> <br />P fate and ZIP Cotle -~ <br /> ~ ~ <br />Postage S .j <br /> ro <br />J <br />Cenllied Fee <br /> <br /> <br />Special Delivery Fee <br /> <br /> U <br />Restrictetl DeNvery Fee '"'~ <br />Return Receipt Shoving, >~ <br />to whom antl Daret4etiv~ea~ -] <br /> <br />Return race t slj~Gring to wt+orh, <br />} <br />~\ <br />~ y <br />ddress of Nve <br />y <br />Date, antl ._ <br />TOTAL Pgstaee and Fr55 3 <br /> <br />Postmark Da / C, j <br />.~ 9~ <br />. <br />~ -] <br />~_~~ ~ <br />