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Permit # ~ - 1 ~ $C~ - ~g~ MV_ a2 Do(o ...- ~,~[ ~ <br />Date: g °~~-D~ Recipients: r-t^_~ ~~ c~~, ~.,Q-,~ <br />TO: ~.t Il')c.~d-ic~ FROM: DRMS <br />Certified Mail Receipt- ~~~V /`~ <br />A, Signature <br />Liberty Mutual Insurance Company <br />175 Berkeley St. <br />Boston, MA 02117 ' <br />3. Service Type <br />^ Cedifed Mall ^ Express Mail <br />^ Registered ^ Retum Receipt for Merchandise <br />^ Insured Mail ^ C.O.D. <br />4. Restdcted Delivery? (EMm Fee) ^ Yes <br />z. ArtideNumlrer 70D5 311D DDDD 2197 7542 <br />(transfer from service IabeQ <br />^ Complete Rems t, 2, and 3. Also complete <br />item 4 if Restricted Delivery is desired. <br />^ Print your name and address on the reverse <br />so that we can return the card to you. <br />^ Attach this card to the back of the mailpiece, <br />or on the front if space permits. <br />1. Anide Addressed to: <br />x ^ AgeM <br />W - ^ Addressee <br />B. Received by (Prin[e Name) C. DMe of Delivery <br />~ ~ r <br />D. Is delivery atldress tlifferent from Rem 7 ^ Yes <br />If YES, enter delivery address below: ^ No <br />PS Form 387 1, February 2004 Domestic Retum Receipt to255saz-M-tsao r <br />