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P 436 789 3590-~K <br />US Postal Service S~. ~ ;O <br />Receipt for C~i~~ <br />No Insurance Coverage Provided. ~ <br />l Mall -e9 rev rse v ~ <br />Do not use f r Intemati <br />Sent to <br />~ <br />Stne16 Nu r <br />P ice, Snte, 8 Z C S'/ <br />Postage S , 3 <br />Cen~ed Fee r /-~ Q <br />Spetlal Delivery Fee <br />Restntl00 Delivery Fee <br />Rehm Receipt ShowNg tc <br />Whom 8 Dale Deliveretl <br />' <br />ReLm Rxe419a~vptc VAlorr~, <br />Dale, 8 bdastees AdAess <br />TOTAL Postage fi Feas a ~ _ 9~ <br />PosbnaAc or Date <br />u <br />c <br />c <br />c <br />a <br />C <br />a <br />c <br />LL <br />V. <br />a <br />~ SENDER: <br />•Camgela items 1 endor 2 for etltlitiorul services. I also wlSh t0 fACBiVB thB <br />e •COmpete Hems s, ae, rW ab. following services (}or en <br />° •Pord Your name erq nddresa on ttre revene of thin form eo Vnl we ran rNUm INS BXVe fBB): <br />e certl to you. fj <br />•pammm this roan to the hom of tna mellpiea, a on Ins mck if span does nol 1. ^ Addressee's Address ~ <br />• Wnle'Refum Reasipr R uesretl' on the m°7 ' below the enicle number. ° <br />o w Pnu 2. ^ Restricted Delivery y <br />•The Retum Rrrceiq will snow to whom the enitle wee dWVeretl end the tlate ~ <br />~ tlNWeretl. (.OnSUIt pOShnesfer for fee. <br />v 'cle Ad~drp\csedC~2""""'/ ~-G 4a. Ardcs Number <br />V` 1 'x.310 7~ X59 <br />b. Service Type <br />° ~~' ~ ud'~'J/~ l~j~ ^ Registered Certified <br />~i _q ~ p' ~ ~^ ^ Express Mall ~ 4'°~Insured E <br />~C~LJ h/ ^ Retum Receipt for Menilertdlss,O ~OD <br />~~ ((~~ 7. Det of Delivery <br />~- ~- acv <br />5. R e' : (Print Name) 6. Addressee's Address (Only!! requested ~ <br />end !ee is paid) <br />g 6. Signs <br />T X <br />• <br />PS Form <br />or <br />December 1994 tozses-sr-e-ons <br />