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• ~ ~~ 335 059 <br />' 1 Y~ CERTIFIED MAIL ~ "~ <br />~~ • PANLE LDVEPAGE PNCVIDED <br />~• ~ r., NDI FOP INTENNATIONAL MAIL • <br />~~~ (See Reverse) <br />1 ~ <br />Sent to ~ fr ~~ Co • ~ <br />d' Street and No~ ~p <br />N O <br />i P O . State ntl ZIP CodeO OQ ~ / on <br />V o ~ICV <br />~ 5 <br />Postage <br />Certdied Fee <br />Special Delrveq FEe- <br />~ a <br />Retdrn Rece~pl sh i l ~~^~ <br />Date~and Adtlress of Delivery <br />~ TO7A ~osta~antl Fe~7•' S <br />~ ~ li'.~_..i <br />rPO$tmark or DafP- - ~ E <br />E <br />°I <br />N <br />a , <br />r -~ <br />{ <br />m SENDER: <br />D Camplele items 1 and/or 2 for eddidanal wrvicaa. I also wish to receive the > <br />m aComplate items 3, Ie, end 4b. following eerVlCBe (fOr art <br />~ '. • Print your name and address on the reverse of this form so Ihel we cenretum thin BXira fee <br />) <br /> <br />j <br />m card to yau. <br />aANach this brm to the hom of the meilpiere, or on the bads it <br />space tloee nal <br />1. ^ Addressee's Address m <br />-° <br /> <br />y pertNt. <br />a Wnte'Retum Receipt Requested'on Ihs mailpiece below the <br />snide number. <br />p. ^ Restricted DBlivery w <br />y <br /> <br />~ .The Retum Receipt will show to whom Iha entitle was delivered and Iha date <br />delivered. <br />Consult postmaster for fee. ii <br />0 <br />0 3. Article Addressed to: 4a. Artcle Number a <br /> "' ~ ~ <br />"" ~ <br />E <br />o <br />v y <br />J <br />/ r t~ <br />•~ ~ g / 4b. Service Type <br />_/ <br />^ Re <br />istered JJ <br />ertified <br />m <br /> <br />w / fl A CQ gU C.r~ <br />x <br />o <br />a g <br />C <br />^ Express ' E~ CO ^ Insured m <br />c <br /> - <br />- <br />-.•. <br />Wo. <br />I ^ Retum a COD <br />D <br /> <br />DS <br />s ~'f1 <br />7. Date I' ery o f <br /> - <br />E, L r <br />~ r <br /> 5. deceived By: (Pont N ) 8. Addr ssee d ( <br />y re ested ~ <br /> and a is paid) ~ <br />~ 6. b1 natur (Addresse r ) <br />0 <br />Ps Egr(n 3811, December is9a Domestic Return Receipt <br />