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" SENDER: <br />• Complete items r eM/ar 2 far eddltional servlcee. <br />I BISO Wish t0 receive the <br />w • Complete items 3, end 4a d b. <br />~ }OIIOWIng BBfVICBa (for en B%Lr8 C <br />8 <br />• Print your name end eddrau on the reverse of this form <br />m eo that we can feel: <br />return this cord to you. <br />> • Attach this form to the wont or the msilpiste, or on the hook Ir space <br />1. ^ Addressee's Address i <br />y <br />does net permi[. <br />i <br />l <br />"R <br />" <br />l <br />b <br />on themeilp <br />ow t <br />• Write <br />eturn geceipt Requested <br />ecebe he ank <br />e num <br />er. Z. ^RBStrlCted Delivery <br />« • 7hs Petum Receipt wrY Show to whom the erticH was deliversdeM the dste <br />e d•Iwored. <br />Consult ostmaster for fee. V <br />o <br />9 3. Article Addressed to: <br />~ 4a. Article Number <br />P l~- lGG SSS <br />~ <br />~~~ r~ <br />~) <br />H <br />~ <br />~~ <br />'g l'~y~~ <br />$( <br />/Yl ~e1A's'H' 4b <br />Service T <br />e ° <br />, <br />~ <br />o ~ yp <br />. <br />^ Registered ^ Insured ¢ <br />w ~ d . ~~ ~`~/ Certified r ^ COD G <br />w <br />o <br />elc P <br />U 8041a ~ <br />pak Cr~ ^ Express Meil ^ Return Receipt for <br />Merchan ise 7 <br />C <br />a . <br />, 7. Oate of Delivery <br />~~ -q3 <br />~ <br />0 <br /> <br />G <br />5. ature IA resseel T <br />8. Addressee's Address (Only if requested ,y <br />f- and fee is paid) ~ <br /> t <br />Q ~ ~:...._....,. ,,,..., a r <br />>: <br /> Spec =~ <br /> 166 855 <br />P 179 <br />' <br /> <br />i . <br />.p <br />p <br />Flle fi <br /> Receipt for <br /> Certified ~Aail - <br />'a) No Insurance Coverage Provided <br />'~ _- <br />Do not use tOr International Mail <br />J ' ° „^Y <i ISee Reversal <br />~ ~m <br />I ~ <br />' , 9 ei ~tl NU~~ <br />y 3 e and Zip Cor1~ A^ J <br />p <br />/I <br />... <br />n <br />L <br />lid (0 <br /> ~ <br />^ <br />M1 <br />L <br />v <br />h- <br />~ Postage lv <br />9 <br />~ <br /> Cem~~eo Fee <br />~ <br />.V Soeuai Deiweiv Fee <br /> Resv¢ren Deeve,y Fee <br />T_ <br /> <br />by Rew,n ReceiO~ ShO4WO <br />~o WM1Om B Daie D e~eq <br />~' <br />yc ReWm Receipt S ~ o WFnm. <br />Date. arts ~m~ see noo,ess <br />~~ TOTAL Pos~a9 ~ !1 ~r~ ~ i ~ <br />~O' & Fees <br /> Postmark o~ U <br />:cam Q <br />~E _ _' <br />:~o <br />LL <br /> <br />