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• ; <br />+ <br />: CMlphts name 1 sad 2 w an adAtiorat urvkN ara daalrad, and compdte Items <br />. <br />and <br />Pue your edUresa in the "RETURN 70^ Speee on the reieroe side, Fallura to do thin will prevent this <br />card from being returned to you, The return sec i 1 ewill rovide ou the nemeo}tne arson deliv red <br />to and the date of deliver .Fora prone acs t e o owmq servrcae ere aver a •. oneu t poatmaeter <br />or e s an c ec c ox as Fora tlitional earvice(el requested, <br />~ <br />1. Show to whom delivered, data, and eddrease~e'a eddraas. 2. <br />O Reattlaed Delivery <br />(fsrro rhorge) (Fsrro rhorgr) <br />3. Article Atldreased to: 4. Article Number <br />wa--v~~ Mtws '~i 'Xo? 4~ 7Z <br />T(7,Iftll~b ~A.SI1~l 14ttN11`1Gt \N%r T~.Pe of Servlca: <br />~-$' f1w,.r ~ LI Repiaterod ^ Insured <br />~~I1.1.~.~ ~Y ,1,.. <br />~t{/~~j ~ Certifbd(L. ^ RODrn Recei~t 2± <br />Exproea~leil ~ for Merchentlle <br /> Always oDteln alpnsturo of addressee <br /> or agent and DATE DELIVERED. <br />5. Signature -Address 8. Addrpssee's Address (ONLY if <br />X I~./J requested wd far paid) <br />6. Signature -Agent ~' <br />X <br />7. Date of Delivery r ~ +^ ^ <br /> <br />Fi Faam 3617r it4r, 1488 • IA8.9p.0. 1001-212-0l6 DOMEOfIC RE7IAIA RE6~ <br />