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co 8232n: Complete Items 1,2, S,and 4. j�j/ 2 3 r. <br /> Add your address In the"RETURN TO" <br /> space on reverse.. �n r 1 <br /> — RECEIPT FOR CEAW'sZO t�,1`�,_ <br /> `j I (COOSULT FJSTnASTEN FOO FEES) <br /> DED- <br /> 1. Tho NDaalne smics Is requested(check one). DED <br /> NO INSURANCE COVERAGE L MAIL <br /> NOT FOR INTERNATIONAL MAIL <br /> Shaw to wham and date de.fared............... _C � � (See Reverse) <br /> j ❑ Shaw to when,date.and addrese of delivery.. _d <br /> I.2. ❑ RESTRICTED DELIVERY........................... 4 t <br /> i (M2 rasnic"&"y to is Harped In Adam STREET AND NO. <br /> mlRa/wive M111'N an.) y <br /> TOTAL S 0.,STATE AND ZIP E n <br /> 3-ARTICLE ADDRESSED T0: POSTAG e <br /> ( :3,)( I Sr1Y A&Jl 131+f/ t� CERTIFIEDFEE c <br /> 0 rt) w V-CCIAL DELIVERY, t <br /> 4. TYPE OF SERVICE: ARTICLE NUMBER T ¢ RESTRICTEDDELIVERY t <br /> El REGISTERED ❑INSURED n r `, L SNDWTOWHOMAnO , r <br /> j;�CERTIFIED ❑C00 21 <br /> m D+rE DELrvERED <br /> II ❑EXPRESS IIAIL r w SHDW in WHOM.DATE. <br /> AND ADDRESS OF t <br /> I (fT=ya dw_,n 812m;era a7 Gddr=z of zOcet) ( g DELIVERY <br /> I tim received the article descrlWd abve. ! " u�i _SHOW TO-WHOM AND DATE <br /> � � ¢ DELIVERED WITH PFSTPICTE c <br /> SIGUATURE ❑Addressee 0 Authorized agent I: o ? DELIVERY <br /> SHOW ID WHOM.DAr <br /> ADORESS OF DEIIVEPY�1 N R c <br /> RESTRICTED DELIVER- <br /> ,--S. DATE OF DELIVERY �� Y/POSTMARK <br /> O — TOTAL POST AGE AND FEEVf 0 \ <br /> N lnW oa an awno two) J I ..T ..� <br /> / U <br /> (D fCJ f`'T n POSTMARK Ofl DATE C, <br /> 6. ADDRESSEE'S ADDRESS Iprry n Rpwmrll <br /> c9 I I) E <br /> g 7. UNABLE TO DELIVER BECAUSE: 7a. EMPLOYEE'S r <br /> INITIALS I�/0. <br /> 4 <br /> a GPO Ndfi�T&eea <br />