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<br /> DIVISION OF MINERALS AND GEOLOGY N~ 2 4 9 0 4 <br /> DATE ~ - r , 9~ <br /> RECEIVED 7 ~ L /~/~ /' ~{~ ~ - $ a~ <br />(rte <br />r S d0 v <br />FROM ~•-' t~ ~ r l~µ~ Lrnn <br />.6iLt.tn <br /> / <br /> / <br />(~ <br />~P.I ~LtJ~i. I~(i.,.r~µ,~ tF nlD ,(x' DOLLARS <br />~JA~ <br />/~ <br /> - <br /> ^ CASH <br />L~ <br />,O r/ lVl"q~5-O~C 1~,}Yt'QI'rt-/G Jc'SSS OMOCK <br />FOR ;Q <br /> • <br /> AMOUNT OF ACCOUNT...........$ ~n'^ <br />O <br />! <br />~ <br />~ <br /> II <br />YL <br />U <br />Q <br />AMOUNT PAID ........ ....... ..$ <br />~ <br /> ~/ <br />~ <br />/ <br />~ <br />~ <br />BALANCE OUE ...................$ BY ~- I Y `CU/-'C_ <br /> <br />L <br />Cks ~u~ y-C~e ~G~cf <br />cf~<< ~. ~ <br />`~ vv~, ~~. 2 . ~ _ <br />~~ ~-~--• Cam, <br />~,~ov~ <br />~, e K ref~''`~ <br />Pig 8~~~a,,•_~-ff4e ~-~ ~~~ ~~ <br />~ ^' SENDER: <br />I • Complete items 1 arv'~r 2 far sdtlitionel services. <br />II • Complete items 3, 'e 8 b. <br />y Print your name en~~ress on the inverse o7 this Corm so that we can <br />return this card to you. <br />~ • Attach this form to the front of the meilpiece. ar on the back it space <br />does not permit. <br />• Write"Return RaceiDt Repuested"on the meilpiece below the article numbs <br />r The Return Pacaipt will show to whom the article was tleliveretl end [he des <br />C tleliverad. ` <br />•~ 3. Article Addressed to: 4a. AI <br />$ Peke- ~le,i~ a- Rtcl+arzo Zfwett ~ <br />E ~ 4b. SI <br />„N ~`~q3 <br />P 179 166 13^ <br />P2C. ~ ~~p <br />Receipt of r <br />o ~ C~rt~~+d110ai1 -z3fi•lL <br />0 No Insurance Coverage Provided <br />CO ~ Do not use for International Mail <br />I O (See Reverse) <br />I a150 WISh t0 reCBIVe the <br />followi ervices (tor an extra Y <br />feel: ~J t <br />1 <br />^ Addressee's Address y <br />. ~ <br />2. ^ Restricted Delivery « <br />•~ <br />Consult postmaster for fee. o I <br />~,le Number c <br />~7`t 166 13c~ ~~ <br /> <br />~ z~~ ~.I <br />~iNG ~NS'+hJC+(ON f• ^ Registered ^ Insured ~ <br /> O <br />'~ Q ~~ t$ L7 <br />1"C~ ..Certified ^ COD <br />i <br />f .q <br />w 1 pt <br />or <br />^ Express Mail Return Rece ~ <br />6 M rchandise <br /> C dv~2 <br />P ~ SJI`{oZ~ 7. Date of Del' y <br /> - ~ <br /> <br /> 5 i resseel 8. Addressee's A dress l n y if requested x <br /> ~ v and fee is paid) c <br />L <br /> <br /> z 6 . Signature gent) ~ <br /> <br />PS Form 1 t, December ,991 4 U.S.G.P.O.: 1992-907-530 DOMESTIC RETURN 1160G <br /> <br /> <br />V <br /> <br /> <br />_ <br /> <br /> <br />Y. <br /> <br />_ <br />.._ ~_ .,- _,_ ._~~_- .a ice Type <br />~ <br />U sem m ¢, s, <br /> E <br />~'• <br />> e~ a~rl to <br />~e <br /> 0 (S <br />C <br />d P.0 . Stale ono ZIP Cooe <br />. <br />0 I <br />~ Postage <br /> <br />T <br />N Cena~ee Fae <br />Z [iCJ <br />E speaal DaLVery r <br />~ 6 <br /> Resmcretl ee <br />~ ~ , <br /> Pewm i 5 <br />>bs <br />4 <br />7 io Wno aie~l~ea <br />1 ael~,~ ee~ s <br />w m <br />f~'AJ Dale, an Adtl a tltl s <br />: d~X <br />(y TOTAL Posl a v:0 . <br />s F <br />$ Z <br />~ <br /> ees - . <br />/ <br /> Poslmalk or Daie <br />a <br />~I <br />