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• Complete items 1 and/or 2 for additional services. <br />• Complete items 3, and 4a & b, <br />• Print your name and address on the reverse of this form so <br />that we can return this card to you. <br />• Attach this form to the front of the mailpiece, or on the <br />back it space does not permit. <br />• Write "Return Receipt Requested" on the mailpiece next to <br />;i. Article Adtlressed to: <br />'~ v+ ~.+~5 ~ tai <br />BI.,E r11t~- S'buE ~ <br />p. o. K3oy- 3o t <br />L yon3, ~o $OSYd <br />~~--- <br />5. Signature (Addressee) 8. Addressee's Address (Only if requested <br />and fee is paid) <br />6. i ur (Agent) <br />~~~~~~ <br />PS Form 1, October t990 cu.s ro:+ t DOMESTIC RETURN RECEIPT <br />P 179 1L 598 <br />h <br />~ Receipt for <br />Certified Mail <br />No Insurance Coverage Provided <br />~~~ Do not use for International Mail <br />J (See Reverse) <br />N <br />7 <br />C <br />tv <br />In <br />N <br />E <br />~CC <br />C <br />TJ <br />~~ <br />~.G <br />LL <br />N <br />a <br />Sens ra A <br />ne Q• ~ L <br />P 9 ~e ana ZIP Cotle <br />- <br />G <br />Passage $ <br />Cend~ea Fea <br />` <br />Special Delivery Fea <br />flesinaeE Delivery Fee <br />a <br />,, <br />ReWrn ReceiOi Sacwmg <br />to Wnom B Dade Debveretl <br />Peimn flece~o~ Snowing io Wnom, <br />Dale. antl Ae4~eSSep'S Atldi ess <br />TOTAI Postage L <br />' <br />8 fees ~} <br />Postmark o~Dare <br />I also wish to receive the <br />following services (for an extra <br />feel: <br />7. ~ Addressee's Address <br />2. ^ Restricted Delivery <br />4b. Service Type <br />^ Registered ^ Insured <br />Certified ^ COD <br />^ Express Mail ^ Return Receipt .v <br />l <br />