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.~~ •\-R r <br />;; SENDER: '= <br />a •Complele items 1 and/or 2 for adtlitional sey~ices. <br />tl •Cornplele ilerM 3, Aa, entl 4b. <br />~ •Pdry yow name end address on the reveres of Ihis form eo mat we can velum this <br />} ~ u to you. <br />~ •Af/adr this form to Ih0 front of the mailpiefA, or on the beck it space tloea net <br />~ a, mm. <br />i y ~Wnte'Relum Receipt Repueared'an the mailpieca below the adide number. <br />i ~ eThe Ratum Receipt will stww to whom the ertide was tleNveretl end the date <br />i C rltlivwed. <br />1a 3. Article AddressEd to: ,y^(,(^! ,~/,(/°f' <br />Im ~ ~ a - <br />a ~j yCY ~ / /y/~ ~J <br />~~ 7 1 J /~J~iR ~ / <br />larrr~ Cry C`, _ y/{~ <br />4 ~~V ~V <br />IZ <br />5. Receivetl By: (Pdnf Name) <br />1 <br />I <br />i g 6. Signature: (Addy ssee or Agent) <br />1,°. X all Y,~G_ <br />~p P,°,.=orrn33ii,Decembertgga <br />t <br />I also wish to receive the <br />following services (tor an <br />extra fee): <br />~ <br />' i <br />1. ^ Addressee's Address ~ <br />- <br />2. ^ Restricted Delivery ti <br />Consult postmaster for fee, <br />.~ <br />JJ G~ ~ `~ <br />b <br />~ u <br />! ~ l~ <br />t~c-~~ <br />1 <br />rpe <br />ar <br />Registered ~Certifiad ~ <br /> <br />Express Mail ^ Insured rA <br />5 <br />Retum Receipt for Merchandise ^ COD <br />Datp,ptpeliery ° o~, <br /> is <br />Addressee's Atldress (Only it requested ~ a <br />and !ee is paid) c <br />° <br /> ~ o <br /> <br /> <br />Domestic Retum Receipt <br /> a <br />Z 1`rx~1 EJr' <br />us Postal Sarvigpl~ ~~r- /-~ <br />Receiptfo}} e <br />No Insurance Coverage Provided. "` <br />Do not use 1nr Intematinnal MaN lSaa mvarsal~ <br />t ~ <br />Q <br />C 7 <br />Post OIFr», Slate. 8 ZIP Cade <br />Pottage a <br />Certitled Fee <br />n <br />Special Delivery Fee L <br />Rgsuiged DeGVery Fe9., r <br />Rehm Receipt % <br />Whom 8 Dale ~ - <br />~ <br />Roam Recaq <br />DaR, d AtlSessee's ~ + .. <br />~ <br />TOTAL Pnaage 6 F~ < <br />Posvnark or Date <br /> <br />ti <br />7 <br />1 <br />1 <br />e <br />7 <br />0 <br />O <br />w <br />