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" SENDER: <br />v aCgnplele i(ertn t enNer 2 for additional services. `~ <br />a .Complete items 3, 4a, and 4b. <br />„ • Print ycurrame end address on the ravens of IINS brm eo that wa wn Tatum 1Ma <br />cartl to you. <br />~ •Al1aU This form to the hoM of the mailpiece, or on the bade it apace dose not <br />~ permit. <br />o •Wnte'Retum Rxasipt Requested' on the mailpiece below the adicle number. <br />.t. •The Relum Receipt will show to whom the erlide was delivered end the date <br />~ ael-iveretlr <br />o ~ <br />a 3. A(~NCIe t~.~rlessed to: <br />~~ ir~t~l . ~: (`~ -fit ~`~ ~:~ `'t t.ta' . '. ', ~:. I <br /> ~ ~ <br />~ •t <br />~ - <br />5. Received By: (Pdnf Name) <br />I I ~l ~cz~~Gar k <br />6. Signature: dd ~sseeprA nt)/J~ <br />r x ~ "~Ci;!z-~_ <br />n <br />PS Forth 3811, December 7994 <br />I also wish to receive the ~ <br />following services (for en <br />BXtra fee): 0 <br />1. ^ Addressee's Address '~ <br />2. ^ Restricted Delivery rn <br />Consult poshnaster for fee. a <br />i~~ 1 ~ r)l ~' _ <br />4b. Service Type <br />^ Registered <br />^ Express Mail <br />^ Retum Recei for Mf <br />7. Date of I e <br />8. Addre e's Addre: <br />and !ee is paid) <br />Domes <br />d ::?~_ <br /> m <br />~( `~ ~G~ <br />.•. ~ <br /> ~ <br /> <br />Certified <br />~I Y <br />~ <br />, <br />^ Insured 5 <br /> <br />Idisa ^ coo a <br />G f <br />~ <br />D T <br />~nlyi/requested ~ <br /> r <br /> <br />