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III IIIIIIIIIIIII III <br />999 <br />P 652 676 pg2 <br />M ~CEIPT FOR CERTIFIED MAIL <br />LL i NO INSURANCE COVERAGE PROVIDED <br />l' M NOT FOR INTERNATIONAL MAIL <br />c <br />//~~ J <br />k~f.c ., (See Reverse/ <br />J y <br />Sant o <br />J~ c ~ • ~, <br />v $ StJset and No. <br />~ ~ i Y' J~ <br />'; '. P.O., State end 21P Code <br />YO <br />N4 <br />.;i ud, Po9ta s <br />(` <br />• Certilled <br />apac~al UBlivery Fee <br />Restrlctetl Delivery ee <br />~~~`~~, R <br />~yCOtow e <br />1 '~ Retum receipt shoring t <br />'7j a Date, antl Atldress Of <br />OTAL Poefage ary'•~y <br />„~ L,: <br />_ Postmark or Date ~ V <br />~LL `, <br />Ca <br />r <br />4 <br />3 <br />r <br />7 <br />w <br />SENDER: CdInplWe items 7, Z, 3 end 4. <br />Put your sddrm {n the "RETURN TO" apsce on the <br />reverse aid6 Fellun to tlo this will prtnMt this card from <br />helnp rtltutrod to you. The rswm recept tee will orovlde <br />Voli tM rleme of tM perwn dNMred to end the dsn of~ <br />delNerr• For Wdltionsl fee tna fopowlnp ka en <br />evalleda. Conflltpgtmeetertor tatm end check.boxleal <br />for ew.vkels) requteted. . <br />1, ~ow to whom, fists end eddrm o7 delivery. <br />Z. ~ Restricted Delivery, <br />3. Article Adtlruaed tod <br />- <br />m <br />IJ -~i <br />Q <br />u Art, pn~ <br />v <br />. use Co - <br />~tn <br />~. 0 Q~ x ~ ~ <br /> <br />4. TYPe o} Serrlp: Article NumDMI <br /> <br />O Registered ^ Imured <br />~CeRititd o CDD .y <br /> <br />pbs a ~~ G odd <br />Ecprm Mail <br />Almys obtain sitlMlu 4 of addrenagegent and <br />DATE DELIVERED. ~ <br />5. Signesure - Addrmee <br />x <br />6. Signature -Agent <br />x <br />Date of Delivery r <br />-s•~r <br />3. Atldrerseal Addren ~ONL K/JYgf <br />1 <br />3 <br />ra <br />a <br />n <br />S <br />n <br />S <br />2 <br />S <br />R <br />T <br />,, <br />