Laserfiche WebLink
z .4 L~pec 2 3 ~. , <br />Receieet~~ for ,upu9e-s3-s3 <br />Certifir~~EfWaii_~/~c-;_ <br />No Insurance Coverage Provide 1 <br />Do not use for International MaiC! <br />ISee Reversal U.J <br />m <br />T <br />m <br />L <br />t7 <br />G <br />O <br />LL <br />a <br />Senuo 6C4 <br />Speer ana No, <br />~~ ~ ~Q ~~ <br />P.0 ,Stale antl 2iP Coe C <br /> d <br />Pgsl pe ~u <br />9 <br />Cegdretl Fee <br />SPec~al Debvay Fee r <br />G <br />flesniaed Delivery Fee <br /> C <br /> <br />fleimn flecopi SM1Owing <br />le WM1OT 8 Date D¢Ineretl _ <br />Hewrn Peceigi SM1Owmg io WM1Om, ~ <br />Dale. one Atltlressee's Atltlress <br />. _ <br />. <br />TDTAL PoSmpe <br />F <br />~ J <br />~ <br />rl 9„ <br />ees <br />& r <br />Postmark of Dale ~ ,e <br />~ '! .. C7 <br /> <br />i <br />.1 r: <br />` T <br /> z.- <br />~. , <br /> ~. <br />~' ~ ~aMplWa~lems yor s mr eddiliorW service6. `! <br />n •Complete itertw end 4b. ~1 <br />m • Pnm your name etldrese on the reverse of this lotm so that we can relur <br />caN to you. .• <br />~ •Aaach ltus form to the hoM of the meilpiece, or on the belt it speoB tloea not <br />o permit. <br />O •Wdte'Relum Faceipr Requested' on the meilpiera below the snide number. <br />~ •The Re1um Receipt will show to whom the adide was delivered and the data <br />C delivered. <br />O <br />. ~ 3. Article Addressed to: 4a. Artlc <br />~ ~ ~ 4b.6 n <br />E <br />Brt,~ Cou..s6r~ Co~yv-n . <br />I also wish JOtdrlilv4 ttie <br />following services (for an <br />extra fee): <br />v <br />1. ^ Addressee's Address ~ <br />2. O Restricted Delivery m° <br />Consult postmaster for tee. a <br />m <br />umber ~ ai <br />'1 b 9i~a 3a 3 <br />type <br />~ Y <br />~~i t `V.~"1 ~, J- ^ Registered $~Cerd~ied <br />~.r7. &K le~i~~^ <br />g 6. Signature: ddre ee Agent) <br />X ~>~~ /:_ <br />a - <br />^ Express Mail O Insured <br />c <br />~ <br /> <br />^ Relum Receipt for Merchandise ^ COD n <br />7. Date of Delive p~ / <br /> <br />B. Addressee's Adtlress (Only i/requested ~ <br />and lee is paid) _ <br /> h <br />PS Forrr~3811, D~~Ernbe1,7994 <br />