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P-~ qS~~~~ J~'r'a 802 <br />}1S Pc+st~8drvic <br />~y~~~iet~`eip~lia~~~etEifi~Sd Mail <br />Np~ynsl~[ce Coderage Provitled. <br />;'~ aid not use.f tote ati n f Mail a reverse <br />u <br />C# <br />f~ <br />C <br />t Ca', <br />oy <br />n <br />~_ <br />Sem to <br />Sor~aca C.J <br />Street 8 Nu ~ r n <br />R' 7 ~ U <br />Post OIfiCB. State, 8 TIP Code <br />t C~ £Iro34 <br />Postage $ <br />Certified Fee <br />Speaal Delivery Fae <br />Residded Delivery Fae <br />f <br />i WA RecdPlb <br />r o b Mate <br />~ mRacriptSM•id <br />Doh, 6 Addressee's <br />SS~TA~~P ge 6Fees <br />` $ <br />~ Postrnark or Dat - ~~ -D <br />~ 1 • <br />'/ <br />. <br />. <br />°' SENDER: <br />V •Complete items 1 endor 2 far additiarW urvicee. <br />18150 Wlsh f0 feC01VB thB <br />a •ComplMa items 3, /a, and 4b. f0110W1ng SBNiCBe (}Dr an <br />wN • Pdnt your name end address on the raveree of this brm so that we can return Ihis BMra fee): <br /> mrd to you. <br />• ea <br />c; this brm to the tram of the mailpieoe, or on the badr it space does not <br />7, ~ AddreSSeB~S AddrBSS ~i <br />~ <br /> <br />m m <br />• Wdte'Retum Recei f R uesred' on the mail lace below the article number. <br />p e4 a <br />2. ^ Restricted Delivery w <br />m <br /> •TTe Return Receipt rill show to whom the arlitle was delivered and the data <br /> <br />aelivared. <br />Consult posbnaster for lee. n <br />. <br />ii <br />v <br />3. Article Addresse <br />d <br />to: <br />4a. Ar <br />tlcle Number d <br />v <br />n rr <br />~~ <br />//~~~//~~ <br />lY /'~..Q.~wJ/Xq <br />I U.eJI~~ l~ <br />r 5~(n y1.1~ SOZ e <br />E . <br />C- ~ ~ <br />~ <br />` 4b. Service Type <br />ii ~-CA <br />~ <br />\ <br />~ ^ Registered $Certified <br />5 <br /> ? unOwan <br />3(eFi00 kC~ ~ ^ Ex <br />press Mail ^ Insured . <br /> <br /> <br />° <br />,~ r, ,,, C q <br />i~_v ~ o ~~ 3 <br />^ Return Receipt for Merchandise ^ COD y <br />c / 7. Date of Delivery <br />Z ~~ I/ 9 r <br /> <br /> 5. Received By: (Print N me) 8. Addressee's A ress ( my it requested ~ <br /> <br />/ / and /ee is paid) _ <br /> <br />~ <br />6. Signatur : Ad ass or en F <br />i. X <br />A <br />PS Forth 3 1, December tssa <br />Domestic Return Receipt <br />