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SENDER: <br />;~ • Complete Items 1 entl/or 2 for eddbipnel services. I e150 Wlsh t0 reCBIVe the <br />m • Complete items 3, end 4e h b. following SerVICe9 (for en eMra • <br />• Print your name end etldrese on the roveree bf this )arm so that we can <br />Y return thia card to you. feet: o <br />• Attach this lorm to the front of the m•ilpisc•, or on the beck if epees 1. ^ Addressee's Addres9 y <br />dose not permit. « <br />b • Write"Ratum Receipt Requested"on the meilpiec•balow the article number. 6 <br />t 2. ^ Restricted Delivery o <br />« • Tha Return Receipt will show to whom the article was delivered end the data O <br />e eelivsred. Consult ostmester for fee. • <br />3. Article Addressed to: 4e. Article Number <br />v <br />E / "l J4ht41 N G O~ f ~0~~4Ny 4b. Service TVPa <br />~ ~ .I /J ppx ~~/ ^ Registered ^ Insuretl ~ <br />I) G rN e/VJe~ ~o ~~~f~y <br />5. Signature (Addressee) <br />n PS Form <br />Certified ^ COD e <br />^ Express Mail ^ Return Receipt for ~ <br />Merchandise <br />7. Date of Delpivrery F <br />8. Addressee's Address (Only if requested u <br />and fee is paid) ~ ~ <br />m <br />,December 1991 C U.s.G.P.0.: 1983-301-530 DOMESTIC RETURN RECEIPT <br />P 179 1665Sp~ SET <br />~ Receipf~pr~~gtf ~~~ <br />v ~ Certified Nla' ~~'an <br />~ No Insurance Coverage Pr <br />Do not use for International Mail <br />.~r•rvM. ISee Reverse) <br />U <br /> <br />•= s ~ rP Cc <br />p.ret4ip ~OGI <br />~ Sveer ana No e <br />y <br />C O O <br />0 P 0 . Scare entl ZIP Cod¢~O <br />~ <br /> OAt J6 <br />In Posrage <br />T <br />N <br /> cenilrea Fe (` • ~ <br />Q <br /> <br />[[ Special elrv Fee':. t <br /> l <br />~ flesmcr D vaJri~~a <br />/~"' <br /> <br /> Pemni Relf~ipr <br />~ <br />ro Wnom A (Pp~r..eretl <br />(/~ Peturn PeceiPr Snbanq'TSv+npr <br />~? Ddle, dntl Aatlre55e2 5 Address <br />fi <br />~-0 i0*AL Posrage <br />B Fees <br /> Postmark or Dale <br /> <br />N <br />d <br />6) <br />I$ <br /> <br />t <br />H <br />