Laserfiche WebLink
$ ~ Complete items 1 endlor 2 for ~otetbnpeR~'cr eP <br />~ ~ Complete items 3, end 4a & b. <br />Prin[ your namesM addresp on the reverse of this form 50 that we cen. <br />• :etutptlfiyj/p~la yau. o <br />m ai~ig tM irdtt grmeinaopieca, at yn ibd peck Rspace <br />r deEe .. . Ei .. ' - . . <br />_ WatesWC{arh ReceiptAequegted"onthem'&tpiec~efowttr08RiClpbanl6E <br />.+ TheReturri~Recep[wiBghowtowhomthpanicleahpgdeGveredand9te tlat <br />e delivered. _ <br />v .3. Article Addressed to: ~ 4a, <br />0 <br />a~Ari~lrt3toc(* Coal ~, ab.: I <br />y 190 /95If St, p~`~~'4 ~ cei <br />I also wish to receive the <br />following services (for an extra ~ <br />feel: ~ ,., 'Z <br />1. ^ Addre6~ee'S~jtldtes~ y° <br />r <br />2.. b Restricted Delivery •m <br />W * Express Mail <br />o DFAU?I'. Ca 3 a ~.2Y ~ \ Ov -r nn.e ,.r nee:. <br />5. <br />ostmaster for fee. m <br />ier <br />733 6r1 <br />o <br />O tnsurea <br />^ COD .G <br />^ Return Receipt for 3 <br />Merchandise e <br />,ry .. <br />3 <br />O <br />rddress {DnIY if requested ~[ <br />it ~ <br />A <br />t <br />~:::~:.~s';L ~~;:; <br />