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iiiiuiiiiiniiiiii <br />999 <br />~. _ __ _ <br />9' SENDER: <br />y • Complete items t antllor 2 for atltlitional services. <br />I also wish t0 reCEIVB the <br />9 • Complete items 3, and 4a d b. fOIIOWing eerviCES (f Or an Extra V <br />• Print your name and address on the reverse of this loan so that we can feel: .7 <br />~- return this card to yeu. <br />• Attach ch~s form to the Iront of th¢ ma~lpiece, or on Me hack i <br />t space <br />t . ^ Addressee's Address <br />h <br />does not permit. <br />m • Write "Return Receipt Requested" on the maJpiece below the arti <br />cle number. <br /> <br />2. ~ Restricted Delivery <br />•" • The Return Receipt will show m whom the article was tleliveretl s W the date U <br />c delivered. Consult postmaster far fee. m <br />v 3. Article Addressed to: 4a. Article Number <br />v ~A~P}I LoP6~ a96 08 06 <br /> <br />BAsrN 2E$(1V~QCES /roc <br />E . 4b. Service Type <br /> <br />^ Registered ~ Insured <br />y i43oo flrGNw/~ l~~ <br />~CertiFied ^ COD <br />5 <br />WES'Tonr t CO• `d 104 <br />~ ^ Express Mail ^ REtllr^ Receipt for <br />Merchandise ~ <br />0 <br />G 7. Date of Delivery <br />Q ~ o <br /> 5. Signature IAddrgsseel 0. Addres,~ee's Address IOnly if requested <br />d t <br />id) <br />0 ~r <br />~ <br />~ ~ ~~ an <br />e¢ <br />s pa m <br />H <br />~ 6. Signature (Agent) <br />F <br />C ~ - . <br />h 6 Form 11. December ts9t au.s.cRO:t~z~zam D ESTIC RETURN RECEIPT <br />