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iii tiiiiiiiniuiii <br />999 <br />d SENDER: <br />a •Cd11pMe eerrle 1 enaol 2 br BddtlblW FwtrNCea. I also wish to receive the <br />e •CwnplMe ileme 3, Ie, anO lb. }OIIOWIng ServiCBS (for an <br />» • Print your none and address o11 the re~arN of ttie tarrtl eo Irul we fen Mum ItYe 9%tr8 fee): <br /> <br />e rerd to you. <br />•AReoh Mie brm to iha hoot of the mallpieca, or on Iha bark if spare dose rrol <br />1, ^ Atldressae's Address d <br />-° <br /> <br />e pertnl. <br />• Wdte'Retum Rlraeipl Aequeeled' on IM mailpiece bebw Iha adide number <br />2. ^ Resldcted DBIiVery o <br />y <br /> •The Relum Receipt will show 10 whom Na enlde was delivered arM the date i7 <br /> <br />u <br />delvered. <br />Consult postmaster for fee. . <br /> <br />0 <br />v 3. ANCIe A/(d~~dressed to: ! / <br />x <br />`~ 4a. Article Number _ _ <br />Z/-~/~c~ X75 Z X05 (~ ~ <br />~ <br />a - <br />S l ~~ K.~l <br />E 4b. Service Type <br />o <br />u <br />~ ~ (~ ~ X Z ~ Z ~ <br />^ Registered .~Certifled <br /> <br />~ <br />^ Express Mail ^ Insured a <br />5 <br /> <br />4 L ' ~~L~ ~ <br />j S <br />~'Fietum Receipt for Merchandise ^ COD m <br /> ~ 7. Date of Der sty <br />" <br /> ~r ~ ~-~ ' <br />~ <br /> <br />5. Received By: (Print Name) <br />8. Addre ee's ddress (Only it requested . <br />~ <br /> - and !Be is paid) _ <br /> <br />~ 6. Signature: (Addre a Agen J <br />o <br />r i <br />4 <br /> Ps Form 1, Decem r 99a Domestic Return Receipt <br />41,6 952 65^ <br />`J`'~ ~~13teipt for '=; <br />Ce tfied Mail '~ ) <br />i ~~j,F <br />y-~Yl~s F(~a~oerage Prov~detl <br />..r.,~ uw ~ Do not use for me rnat~onal ASdtl <br />)See Reverse) - - <br />m <br />m <br />0 <br />0 <br />c+[7 <br />C <br />O <br />W <br />N <br />a <br />sn.~, <br />T• P• Sc l~ .. ~ v <br />_~,. f3~~ z~z <br />cb ~a`f3S <br />~~ <br />l <br />(b.. <br />rn i~~~ <br />Ce.~'~n1 F=.. <br />Sc. ~ ~,~ ), .r,,. r,... <br />R- ,,, ,... . r. <br />Rew,n Pe4 ~C' Sroni~q <br />io tYnoT. B ~a, _~ ., ,. u <br />ReL~n Revwl 5^0.. ~y 'n lYrio+~ <br />Darr a.q san~ , n1me~ <br />•0'A. PC.~aAu.r J ' <br />t <br />a Fp ~ <br />Posrmark oal)aie ~ <br />Iv <br />O <br />r~ <br />~. <br /> <br />