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REV95705
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REV95705
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Entry Properties
Last modified
8/25/2016 3:20:39 AM
Creation date
11/21/2007 11:51:32 PM
Metadata
Fields
Template:
DRMS Permit Index
Permit No
C1981023
IBM Index Class Name
Revision
Doc Date
8/15/2005
Doc Name
Certified Return Receipt
To
DMG
Type & Sequence
SL5
Media Type
D
Archive
No
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C-IG gi-~)~~ <br />l~ <br /> .. <br /> . ,. . <br />~7 <br />D.. <br />. <br />.. <br />. <br /> <br /> <br />~ ®® jQ~,. <br />f~~°v' Ye~fl ~y. <br /> Postepe $ y <br /> <br />r ~ti <br />p CeNOetl Fee Grp C.o <br />0 <br />p <br />Realm Redept Fae <br />(Endorsamem Required) <br /> <br />~ ~ ~ <br /> <br />Qrij ~: <br />p <br />m ReaMuTed Delivery Fee <br />(EndoBamem Required) `~+ <br />'~1 '1~~7 J5 <br />rR <br />l ~ 2 <br />$ S <br />~ <br />~ ~ <br /> Postepe 8 Fees <br />lbta - ) <br />, . -~__ _ <br />S , <br /> <br />p <br />o T <br />O <br />/ a~fi te(tL <br /> <br />~` ____________ <br />ku`fie-9-E i1"pt1Yo.;-----. ~G7 w .S <br />or PO BOx IJa <br />Y <br />~ <br />f __________________ <br /> --- co .. <br />- -------, <br />---- <br />-- <br />------ ---- ---------- --- o S <br />GI}: uFmre: ZIPW n s ~, ~ s ............--- <br /> <br />~~7 <br /> <br />^ Complete items 1, 2, and 3. Also complete A Signature <br />item 4 if Restricted Delivery is desired. ~' <br />^ Print your name and address o the reverse X .-,~" ~~ <br />so that we can return the card t you. R. Received by (Panted Name) <br />^ Attach this card to the back of to mailpiece, <br />or on the front it space permits. ~ <br />1. Article Adtlressed to: <br />~~l /1/~a//1'f/r//eZ <br />Ssi7~ ~/!3fiway~J~ <br />~A' SOS 4 Spa f- /'r~3~ Co <br />S~i47 <br />^ Agent <br />C. Date of Delivery <br />E . l/_.~~ <br />D. Is delivery address different fmm item 1? U Ye! <br />If YES, enter delivery address below: ^ No <br /> <br />3. Se ca Type <br />Certifietl Mail ^ [zpress Mail <br />^ Registered ^ Return Receipt for Merchantlise <br />^ Insured Mail ^ C.O.D. <br />4. Restricted Delivery? (Entre Fee) ^ yes <br />'2. Article Number <br />((master fmm service laoep~ - 7004 1350 0001 1636 8951 <br />Domestic Return Receipt <br />t0259Se2-M-15-00 <br />
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