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STICK PoSTAGE STAMPS T6 Afl1 <br />CERTIFIED MAIL FEE. AND CHARGES FOR <br />1. If you want this receipt postmark¢tl. 51¢k Ue w <br />the article. Leaving the receipt atladhed, and pi <br />hantl it fo your rural carnet. (no ealra Charge) <br />!. II you do not want This receipt pbstmarpetl, zM <br />side o11hE arlidlE, dale, detach and retain the r <br />II you want a return receipt, write the certiliEd- <br />receipl cartl. Form 3811, and attach it to the Irr <br />permil5. Olherwis¢, alhz Id back oI article. En[ <br />atljacent to the number. <br />If you want deliv¢ry restricted to Ih¢ addre55e¢ <br />endorse RESTRICTED DEINERy on the tram or <br />Enter lees for Ih¢ services requestetl in the app <br />receipt is requested. check the apPhcable blaf <br />Save this receipt antl present it it you make inq~ <br />I <br />4 <br />i <br />y .,~...~.. ~-- __ - _ . <br />.w~.•am..tnm.'Gi7vfMto rt0a.+ <br />sera <br />~-~-- <br />1. The faiowilEwN.~e y ~^-9rrEled (thee! aEeJ <br />'~ SYo~ m ~ Eud~date ddivemG...........~t <br />~`y'~r>.. to vhem. dste Ead addrm of ~tltetf..~C <br />^ RL4TRSCi'PD pEt]VVi1tY <br />iow to rrLom snd daU deDveab...........~ • <br />~] BFS'iRIC1FD UEWPRY, <br />$ow to ~tn4 date, and addrco roE del;•an'3_- <br />(CO\SULi'lC9TMASIER POR FFS3) <br />i ARra~EAr~Dgc~°~*r~-) ~ lot Crt FlA~ts <br />ti'. c Lc.rt(' t. <br />p.e.,3~a aBodTX ~SUt~ <br />CeeP~as c.~s~; <br />3. ARTICLE DESCRVTION: <br />i RE04T1RED MD. ( CERllillD N4 I ~IptREO NO. <br />1 line elaiYed tF2 artJe daacsied alwve. <br />HiONATUIIE ~~~ QAatL~a~~~ <br />0. ADDRESt iCairr ~ <br />~. <br />{tR0 t TEi~>b~ <br /> <br />.5 ~ __~_ <br />1 <br />1 <br />1 <br />N <br />f <br /> <br />