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<br />• <br />3 <br />m <br />r <br />7 <br />O <br />Y <br />3 <br />R <br />V <br />1 <br />n <br />7 <br />R <br />C <br />S <br />2 <br />a <br />C <br />i <br />SENDER: Complm items 1, 2, 3 _rtd 6. <br />Put your atltlresi in the "RETURN TO" space on d[e <br />reverse sitle. Failure to tl0 this will prevent [his cartl Irom <br />bNng rburnW to YW. TM return recebt iw will provide <br />YOU the rwna of Me parson dNirbeO to aM the date o} <br />daYrer .For WyltionN tea me 7p11owirq Nrvicb are <br />wNlable. Corlwlt postmaNer for faa and check boxlbl <br />far servicNal raqubtad. <br />~ <br />1. <br />Show tQ whom, data and sdtlrea of tlalirery, <br />Z. ^ Rbtrp.idp Delivery. <br />7. Article Adtlr6ssetl to: <br />~ <br />• <br />~ <br />p,-„~, <br />~ ~ <br />, fie. <br />~ <br />~ <br />/,9 e ~ g/ai~ <br />q <br />;~, <br />4. TYPe of Service: Article Number <br />g Registered ^ Insured <br />RS Certifil:d ^ COD p <br />P <br />/_Pd~C~~a / <br />LLLJ77 Express Mad O <br />l(JO <br />Always obtain signature of addrnsee or agent and <br />DATE DELIVERED. <br />5. Si tun - AtldreaN t <br />X <br />6. Signature - Agent <br />x ~ '~\ <br />T. Date of Delivery ~ (1 <br />v ` t <br />P <br />'t <br />e. Atltlressw's Atltlress (ONLY i requl!~j Ce pt <br />unr. <br />/ ~ <br /> <br />P 068 279 681 <br />RECEIP7 FOR CERTIFIED MAIL <br />O NO INSURANCE COVERAGE PROVIDED <br />NOT FOA INTERNATIONAL MAIL <br />(See Reverse/ <br />M <br />r~ t <br />Q 9 <br />a <br />C <br />~. q <br />v <br />c <br />^1 a <br />~\ <br />w <br />m <br />~~ <br />LL <br />M o <br />~n ~ <br />Q E <br />~ IL <br />N <br />o. <br />~^ <br />Senl to <br />i~7orJ~l/ <br />liJ'j~~ <br />Street an No. ~ 5~~ <br />P.O., S eta antl ZyP Coda p/ <br />~a <br />'~ <br />U/l Ul t <br />' <br />Postage s <br />Ce <br />Special Delive Fae <br />Restricted Delivery Fee <br />Return Rece <br />'° DI ISION <br />Return receipt showing to whom, <br />Date, and Address of D <br />70TAL Postage a <br />, <br />Postmark or Da ~C ~ <br />7 <br />rn ~ <br />r ~~ JO <br />GZ <br /> y <br />. d <br />