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1996-10-10_REVISION - M1984099
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1996-10-10_REVISION - M1984099
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Entry Properties
Last modified
7/12/2022 1:53:47 PM
Creation date
11/21/2007 2:50:59 PM
Metadata
Fields
Template:
DRMS Permit Index
Permit No
M1984099
IBM Index Class Name
Revision
Doc Date
10/10/1996
Doc Name
RECLAMATION COST SUMMARY FORM
Type & Sequence
SO2
Media Type
D
Archive
No
Tags
DRMS Re-OCR
Description:
Signifies Re-OCR Process Performed
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to SENDER: <br /> a mComplete items t and/or 2 for additional services. I also wish to receive the <br /> m •Complete items 3,4a,and 4b. following services(for an <br /> ore Print your name and address on the reverse of this form so that we can return this extra fee): <br /> tZ card to you. m <br /> j -Attach this to"to the from of the mailpiece,or on the back if space does not 1, ❑ Addressee's AddreSS u <br /> e permit. <br /> Recei f Requested'on the mail ece below the article number. t <br /> d v eq W 2. ❑ Restricted Delivery rn <br /> 07he Return Receipt will show to wham the entitle was delivered and the date a <br /> delivered. Consult postmaster for fee. <br /> O N <br /> v 3.Article Addressed to: 4a.Article Number <br /> = - G5z 5�z� <br /> a <br /> E 4b.Service Type <br /> 3 (lUlfL hnt�ruC� �Or� <br /> ❑ Registered ❑ Certified <br /> Mm rn <br /> 30Z LD ❑ Express Mail ❑ Insured 5 <br /> a <br /> o ❑ Return Receipt for Merchandise ❑ COD <br /> Co 71,W <br /> 1, Uf 1 lid <br /> a <br /> 5. eived By:(Print Name) 6.Addressee's Address(Only if requested c <br /> F' and fee is paid) c <br /> F <br /> g 6.Slgna ddressee or Agegt) I <br /> a° a /l <br /> A <br /> PS Form 3811, December 1994 Domestic Return Receipt <br /> Z 4L6 .�52 582 <br /> e ail <br /> ...ante Coverage Providgj <br /> Do not use for International Mal <br /> (See Reverse) CJ <br /> as sent Inn (� <br /> Os •F 1, <br /> t d I anti No 1 !� <br /> E D <br /> m , <br /> OPD.s Ie aodG rye 0 Q)� Y <br /> Q1 Postage <br /> E Wndfied Fee _ <br /> `o <br /> LL SPer al Delivery Fee <br /> FrD <br /> a - <br /> Resu,c,ed Deovny Fee <br /> Return Receipt Showing <br /> tp Whom&Date Delwered - <br /> Return Receipt Show,ng no Whom. (_ <br /> Dare,and Addressee's Addren <br /> TOTAL Postage r% <br /> &Fees O <br /> Postmark or Date- '� C:) <br /> 3® <br /> �996 , <br />
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