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: CtxnpMte iteme 1 end 2 when eddhlonel wrvkee ero dseired, end wmplsro home <br />• 3 <br />d ` <br />. <br />en <br />Put your eddrue in the "RETURN 70" SDaes on the reveres Bide. Failure to do this will prevent this <br />card hom being rotumed to ou. TM rotum rodslot fee will provide you the nsms of the canon delivered <br />- <br />to and th et 1 d I w .For aaaRt one <br />ITiee t Lei !~ w rp »rv se ero ev a T. oneu t pos m star <br />r n c se: ~ox se for edditionel wrvicelel rpuetted. <br />7. Show to whom gathered, date, end eddrsewe9 eddrso. 2. ^ Rsttrietsd Delivery <br />(F-*Tra rMrge) (FSmt charge/ <br />3. Article Addressed to: 4. Article Number <br />~~.~esr ~ uJ~„d~ ,0~/r~ /o S y5' ~ $ <br />O /~ <br />!i ~~dX ~~/,J pe of Servke: <br />Repittered ^Ineuretl <br />//~'~/ <br />~//"i/4 %iq <br />CG ="a C~lea ^ COD <br />~ oe Meil ^ Retum Recai~t <br />~ /or Marchendlee <br /> Always obtain eipnaters al addressee <br /> or agent entl DATE DELIVERED. ' <br />5. Siena re - Ad rase -~ 8. Addressee's Atldress (ONLY if <br />X ~ <br />` ICQYL3rG/1 aid fl[ Paldi <br />6. <br />Signature - Agen ~ G, ~/~~~ <br />__ <br />x 7 <br />7. Date of Delivery ~ ~~~j ~'t7 C7 ! <br />-~f~ <br />M Form ~~ ~, Met. 1%! • U.S.QP.O. 1SSS-272-SS6 DOMESTIC RETURN RECQr7 <br />l~Z~1'_ P 427 345 128 ' <br />'~/ RECEIPT FOR CERTIFIED MAIL <br />'r a ND INSURANCE CDVEMGE PROVIDED <br />G 7 NDi FOR iNiERNAiIDNAL MAIL <br />a <br />u <br />m <br />tT <br />d <br />C <br />7 <br />O <br />m <br />E <br />0 <br />LL <br />N <br />o. <br />/See Reverse) <br />Sent to r <br />r r= v ~o , <br />Sir and No/ / <br />P O. Stale entl ZIP GDd¢ <br />'-<< . .. <br />Postage ~ S <br />Ceddietl Fee <br />Speoal Delivery Fee , <br />ResU¢led Delivery F <br />Return Rece~pl showing <br />to whom entl Dale D¢Irver¢d <br />Felum R¢c¢Ip\ shOwrng ID WhDm <br />Dale. and AdtlreSS OI Delivery <br />TOTAL Postage and Fees 5 ` ~ <br />l J <br />Postmark or Dale <br />