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h <br />v JENDE1i: <br />m • Complete Gems 1 andlor Z for additional services. <br />I also wish to receive [he <br />y Complete items 3, end ae 8 b. following Services (for an extra ~ <br />• Print your name anA adtlress on the reverse of this form so t hat we can feel: 'S <br />d return this cars io you. <br />• Attach this Iorm to the Iron[ of the mailpiene, or on the back if space <br />I 1. ^ Addressee's Address <br />y <br />dOaS n0[ pelmll. <br />m Write "fleturn Rece~pl Requested" on the mailpiece below the article number. <br />$ <br /> <br />2. ^ Restricted Delivery <br />C <br />•d <br />• The Return Receipt will show 1o whom the anc~l¢ was delivered au0lhe tlale tl <br />o aehverea. _ Consult postmaster for fee. rD <br />v 3. Article Addressed [o: 4a. Article Number <br />Pras Orolw~d va(Ie <br />Co~.I Co~ <br />a C - ~ Z9~ 527 K$~ <br />r <br />Y <br />p_ <br />E h,{ Q <br />U P D ~O .y r '/ -1 ({ 4b. Service Type <br />^ Registered ^ Insured <br /> <br /> <br />N <br />w <br />/~ I~ <br />D p / /J <br />1 ~~)fQ ~ 0 `~I~$ <br />Certified ^ COD <br /> <br />^ Express Mail ^ Return Receipt for ~ <br />~ <br /> <br />~ <br />¢ ) Merchandise w <br />~ 7. Date of Delivery <br />~ ` ~ <br />¢~ 6. S n• <br />3 <br />0 <br />> PS Form <br />N <br />ii is-~~ <br />8. Addressee's Address (Only if requested Y <br />and fee is paid) ~ <br />ro <br />t <br />h <br />t ssl <u.s. cvo: tr,cz-axa..ln DOMESTIC RETURN RECEIPT <br />