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;~ <br />SENDER: CornpNts itlims~l, 2, 3 and 4. <br />Pu'Wnur in the •'RET RN TO" tpaca On tM <br />rwerie side. Failure to do this rill prMnt thilcard irpm <br />n rsY t II r vide <br />b <br />r <br />being raturnW M you. TM n <br />,s~ <br />r; <br />~~ <br />y0Y tM name Of lM parson ^~ -- IO end 1M deal Of <br />dq_ IvNV. FOr edditionel feel tfiPP fOllOwinp Yrvlees M <br />available. Consult postmletar f~r fees end check bo+tlasl <br />for servicels) requesretl. <br />t. ,Show to whom, data en8 eddre>seMNMew. <br />i <br />2. ^ Restricted Delivery. <br />3. Article Addreled t0: ~ . <br />m~. ~~ Le:~.yck• <br />f~csrcts S~~J- <br />(JC~a~cJ~-a.~c <br />~~ <br />, <br />.. <br />15 l-ca.a- r rre~. , Su:~`e ~ So <br />I <br />F <br />; <br />~ <br />~~ <br />~~ <br />`` <br />JG't C:£Y~ CrJ~ gp~JO~+- <br />4 Type of Service: ~nrtide Number <br /> <br />O Regatered ^ Insured <br />ertified ^ COD ~CC-,8 ~~3 3C'f <br />Express Mad <br />Always obtain signature of addresseeQr,agent and <br />DATE DELIVERED. <br />5. Si n re - dMelre <br />x ~ <br />6. Signature - Aplrrt <br />X <br />]. Date of f]elNary <br />~~ 8. Atldr d a <br />I <br />I <br />I <br />T <br /> <br />A <br />V <br />v ~.i <br />~ P 068 2B3 ,.~4 <br />a <br />Li <br />1, <br />W <br />9 <br />t ~ <br />w 4 <br />~~ <br />mm <br />~o <br />-j' i <br />v <br />-vi <br />_~ <br />~ ~ <br />N <br />S <br />m~ <br />~~ <br />ttJ <br />o <br />,LL <br />°o <br />a~ <br />~ o <br />•LL <br />1 i <br />RECEIPT FpR CERTIFIED MAIL <br />NO INSURANCE COVERAGE PROVIDED <br />NOT FOR INTERNATIONAL MAIL <br />~.~OJ Cr-8S-7o2 <br />C -CV R -~' 1(See Reverse) rn s c <br />Sent to her ' ` E~ e-".~ tc- ` <br />X2»0.0„-. ~ ~.ESCta.c~~ Sa=.trU <br /> <br />Sireel antl)I N--o. ~ c _f~ <br />~(iJ 1 n Jug-~`c ~lJ ~- <br />.0., Stale antl ZIP Cotle <br />i=w:SE C •~~0~~ <br />Postage s <br />Certified <br /> <br />li'_ <br />SPeclal bllirety:Fd6A t~ ~ '. , <br />' +^! <br />7 ~~ <br /> ~ <br />• ~::/ <br />Re9lricletl Delivery Fee <br />Return Raceipf Sho g <br />to venom antl Date Delivered <br />Retinnriec'91Pf ~r~glp~O nyeo~, <br />D <br />d <br />atp•an <br />Addresso ~Detfrgry;r ~ _ -r E}„ <br />TOTAL Postage d'~eeE`.i`~ ~ _ ~ .;, ~.._y_.. <br /> y. ^ <br />Postmark or ~~ <br />~ <br />, <br />~ <br />t <br />,~># vSY <br />) <br />~ <br />te <br />,,t <br />l. T <br />,,c <br />, <br />~ <br />9 ~ / <br />~~ ~ , <br />