Laserfiche WebLink
III IIIIIIIIIIIIIIII <br />RECEIPT FOR CERTIFIED MAIL <br />ND INSURANCE COVERAGE PRDYIDED- <br />MOT FOR IN7ERNATIDNAL MAIL <br />a'fl ,s~arE n Gila woe <br /> / ~ ~j ~ ~ 170 ) <br />POSTAGE $ <br /> <br />N TERTIFIEO FEE t <br /> <br />W <br />w C <br />SPECIAL DELIVERY _ <br />Q <br />s RESTRICTED GE.IVERY - <br />- <br />o - <br />' ~ u SMCW I9 WMCM. }NC CzR <br />H > > 7b wERO 2 <br />< ~ W <br />~ ~+ cn 5{9N R' WHOM pAR AhC <br />~ <br />N ,i ~ OCCFE4 DI CEU'IIX1 6 <br /> W __ <br />~ W SHOW 10 WHON px0 DAP <br />~ i <br />a <br />H ' o ~ oflufaEO wrv. X[StrtiCTIC C <br /> <br />~ ~ m <br />~ } lUVfPr <br />SdAW i0 WHCM OAq ANO <br />i Blue zCOPF~pr 9`~~, oPr Wn4 6 <br />TGTAf PGST <br />POSTMAfffjjj111000 f <br />i <br />o <br />x <br />\. <br />~ ' <br />a <br />/ ~' ;mil -i, <br />~~'., <br />~ - <br />~ _ ,, <br /> <br />fl <br />3 <br />< <NDER, Complete items 1. 2. antl 3. <br />Atltl your etltlress in the "RETURN i0" specs <br />reverse. <br />1. The following service! is requested (check one). <br />^ Strow to Whom and date i)ellvered ... ..... _¢ <br />^ Show to whom, date. and address of dellvery .. _¢ <br />^ RESTRICTED DELIVERY <br />Show to whom and date delivered....... ..._¢ <br />^ RESTRICTED DELIVERY <br />Show to whom, date, and address of dellvery S_ <br />(CONSULT POSTMASTER FOR FEES) <br />2. ARTICLE ADDRESS~p TO: <br /> <br />3 ARTICLE DESCRIPTION. <br />REGISTERED NO. CERTIFIED NO. INSURED NO. <br />49valP~ <br />(Alwsys obtain sipnelure of addressee a agent) <br />I have reserved the article described above. <br />SIGNATURE ^ Addressee ^ Authorized agent <br /> <br />DATE OF DELIVERY POSTMARK <br /> ~, <br />5. ADDRESSlCOmpfete only it ropuestetl{ <br />6. UNABLE TO DELIVER BECAUSE: CLERK'S <br />1 <br />x <br />rr <br />c <br />s <br />z <br />x <br />R <br />m <br />SYGPO~ 1 9 77-0-219 585 <br />