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-- <br />• P 161 956 512 <br />~ SENDER. -- - - ---~- - ----- <br />rn Cpmp~N rtama t and/or ]for eddiYOnd !snits!, - - - <br />-^I also. wish to receive the <br />m comp4t. ii.ma a. .ne de 6 e. following services Ifor an extra <br />` ! Pnm your name and addrua on rM mvarae of tMs form so that we bn <br />' fee)- <br />' > <br />m <br />return Nis card to you. <br />• Attach this rprm to the front or the mailp:ect, yr on the back it space 7. ^ Addressel~5 Address to <br />does net permit. <br />m Wriu "Return Receipt Peppasted" on the melDiece below the anlc4 numbs <br />2. ~ Restricted Delivery n <br />e <br />Te Return Recuot w111 show to .vhom the article was d<tivend >nd the oate u <br />c +end. COnSUIt postmaster for fee. m <br />~ 3. Article Addressed to: 4a. Articl <br />e Num <br />b <br />er ~ <br />m <br />-° <br />~ <br />h (( <br />~~ <br />)) <br />~ ~lP "1 <br />? <br />n <br />~ <br />~ <br />~ C~\Q <br />~'Cb~C' <br />4b <br />i <br />T <br />S . <br />_ / <br />2 <br />, <br />o •C/Jb~ C~ . <br />erv <br />ce <br />ype <br />^ Registered ^ Insured <br />u ~at~ ~h~, mr\ <br />n ty <br />Ql Certl}ied Q COD C+: <br />5 . <br />L CC'r~c.1 ~. ^ Express Mail ^ Return Receipt for ~'. <br />2 t <br />D <br />~ ~3~ Merchandise `: <br />~ <br />\ 7. D to of Delivery <br />2 ~ <br />r <br />^ o; ~ <br />m <br />L 5.' S gnature (Addressee) ~ ~ 8. Addressee's ddress Only if requested .dt ~ `= <br />7 _ ~ ~ ~ antl fee is Paid) . ~ ~ <br /> <br />~ ~ ~ ~ , .o <br />4 <br />6. Signature (Agent) ~ I-, <br /> <br />j ~ ~~ O <br />O <br />s m <br />PS Form 3811, December 1SS1 *u.s.dPO tcpa~.rta DOMESTIC RETURN RECEIPT ~ <br />E <br />` <br /> c <br /> tr <br />0 <br />)uttt: , - <br />mple[e itama 1 and/or 3 for adtlitioml servfcaa.:\ <br />mDlete item! 3. end d• 8 D. <br />nt your name end address vn the revery of this /arm a° that we can <br />[ thin card t0 You. <br />bph this 7orm ID tM Lont el the meilPiape. Or On the back it !papa <br />nm x. <br />rte n Receipt Repvested" on the mailpie<a Delaw the article num er <br />a petu,,, Receipr will show to whom the article was dalivared antl the date <br />nd, da. An <br />Article Addressed to: <br />/'~ ~ <br />aq. service YP ~ Insured <br />^ Registered ~ <br />Certified ~. .~ COD N . <br />Return Receipt for a .1 <br />Express Maif " d Merchandise ° ; <br />7, p~e of Delivery " -~ ~ . ~ ~ ~ <br />/ (! _ y o . <br />r• <br />$, Addressee s Addr 5 4 .nly rl requested o'' <br />and fee is paid/ L <br />~i 1- <br />,,-eYecerve ~tne <br />ices Ifor an extra - l .. <br />y <br />following serv <br />fee): <br />~, ~ Addressee's Address <br />to '. <br /> <br />n Restricted Delivery <br />Z 6: <br />'m <br />, <br />Consult Postmaster for fee. ~ ' 2 ~~ <br />cle Number ~ <br />19\ GSI~ 5~~ E <br />~: <br />m <br />. <br />7 e ¢~ <br />Orm <br />camber T <br />eUS. GPOaiaJ~Z'Ta UUIYIGJ s w <br />US Postal Service <br />Receipt for Certified Mail <br />No Insurance Coverage Provided. <br />Oo not use for International Mail (See reverse) . <br />:YrL~nt 10 <br />C~Gc\ ~ \ \ <br />Slreel b NumDe <br />~ <br />~ <br />~ <br />-a,. <br />C,p3w \ <br />. <br />st On~~5lare.8 IP COd ~ ~ \ <br /> \ <br />Postage $ . ~ 2 <br />CerdTeE Fee ,~S <br />SpeGal DelMery Fee <br />ResldCCd DeG.ery Fee <br />rlclum Recepl Shpwin to ~ ~. <br />tmom d Dare <br />Fcvm Fn ~~ <br />Cale. 8 M/ <br />TOTALP Qa edF b $J Z•~ <br />Postmark ~ 'e ,9~ <br />U75P5 <br />P 161 956 521 <br />US Postal Service <br />Receipt for Certified Mail <br />No lnsurante Coverage Provided. <br />On not use for International Mail (See reverse) _ <br />N <br />in <br />4 <br />O <br />O <br />m <br />r•s <br />0 <br />LL <br />Sent to `' _ <br />,•- ~r Dc <br />Slre L umber ~ n ~~ <br />t Olace, yule, d 21 ~°da ~ ` <br />Posla9c S <br />Ceruded Fee <br />Special Delivery Fee <br />Fkstrided Delivery Fro <br />Return Retspt S+wttirq to <br />NRtam d Dare De6vend <br />Ream Repe'pl Shca*gb Whon, <br />gale, i obi <br />TOTA .Q S <br />Pos Da ~ <br /> v ~J IJ <br />/J <br /> -• <br />:J e <br />a ]99T <br />r,..,< <br />AE7UR <br /> <br />