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m <br />9 SENDER: <br />•Complete items 1 anNOr 2 for etltlitional aerwcea. I also wish to receive the S' <br />~ <br />n •Complale items 3, 4a. Mtl <b. <br />our name antl etltlreaa on Ne reveres of Ihls loan ao that we <br />• P <br />int <br />can rrnum this fOfiOWing SerVlCea (fOr an 1 <br />~ <br /> r <br />y exits fee): i <br /> <br />j card to you. <br />• Aaach Ihia form to the hom of the mailpieca, or on the back if space does not <br />1. ^ Addre55e9'S AddreSS e <br />,! <br />~ <br />} <br />`y • Wn e1Relum Receipt Requested'on the meilpieca below the anicla number. 2. ^ RBStdcted DBIIVBry y <br />y <br /> •The Relum Receipt will show to whom Ne artitle was tlelivarad antl the tlate <br />delivered. <br />Consult postrnaster for fee. <br /> <br />. <br />°~ <br />~ ~ <br />v 3. Article Addressed to: <br />~ Coo I ~ok~, pan <br />~- <br />( <br />~ 4 cle Number <br />5'~ (o ~3 ! 3,32- w <br />i <br /> r <br />o t.~~ <br />~ <br /> <br />Q <br />5 ' <br />~ 4D. Service Type <br />o ~ <br />¢ <br />u . / ^ Registered ^ Certified i <br />w <br />y <br /> <br />ic /-~ ~ <br />V 2 <br />~YV12Y5~ g ~ 3 y ^ Express Mail Insured <br /> <br />tiS 5 r <br />01 ' <br /> ^ RetumRece~tforMe I(&s <br />C <br />0 7. Date of Delivery <br /> <br />z ~. o <br />;. + <br />~ 5. Received By: (Print Name) R. Addressee's Add ess (Onl i r que ~e <br />~ ~~ ~ ~ i <br />m s <br />w and /ee is paid) <br />v r , <br /> <br />c <br />6. Signature: (A sse r ge <br />~( ~j'~ <br />3' ~i i- ; <br /> <br />X ; <br /> Ps Porte 3811, December issa Domestic Return Receipt <br />r <br /> <br />P ifA7<','~ 4 31 ' 3 3 2 <br />e 'C~J <br />r Certified Mail <br />ae Coverage Provided. <br />for International Mail /See reversal . ~ <br /> <br />u <br />°a <br />C <br />C <br />G <br />R <br />4 <br />U <br />Q <br />~~ <br />to <br />S , <br /> <br />C i.~J lr - -~ ! 1 <br />ost Office, Stale, 8 IP e <br />4~3 <br />8 <br />~ o <br />t <br />Postage ~ ,~, _ <br />-,S: C , ~ t <br /> ~ <br />~. co <br />Spedal Delivery M ~ t t <br />`~, c <br />-~ c. <br />~ <br /> . <br />1 T. <br />Rasidtled DBFre Fie ~~ <br />I x J <br />~ ReNm Receipt Sho tOS 'y t j <br />Whom 8 Dek Delivered <br />F Regan P.ecePt Stoxi~gta Y1gm, _ <br />Dale, 8 Adhessre's Atldress <br />i <br />~ TOTAL Postage d Fees <br />i <br />a <br />~ PosMad or Date <br /> <br />1 <br />i <br />f <br /> <br />1 <br />J <br />i <br />