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d SENDER: <br />v •Complete items t anNar 2 for etltlidonel aac~ ~Ft~~Q (~[~ ro <br />is •Complete items 3, da. and Ib. M1~ <br />~ •Pdm your name antl address on 1tlRlrt~r11A1111~N~s67QL1~Fi <br />card to you. r''~.C ~~y~./~pp~~p/yr~r <br />.j •Aaach this form to the hoot of tra~a/^s~p~e~y~~~0ap\I/6./~~apYrQY~S~p!6'Utde3pfibl( <br />v Permit. riflP6 maePre~.A d91MO Ri6~Rf1 ~6~ <br />y • Wdte'Relurn Reteipl Requestetl' o c a num ar. <br />$ •The Retum Receipt will show to whom the enitle was tleliverec end the date <br />C tlelivered. <br />O <br />a 3. Article Addressed to: 4a. Artic <br />Z <br />E PAT T~I~ ` - -- - - 4b. Serv <br />23305 ROUIT <br />I also wish to receive the <br />following services (for an <br /> a wv/. Y . <br /> . ^ Adtlressee's Address •°- <br />Z <br /> 2. ^ Restdcted Delivery y <br /> Consult postrnaster for fee. <br />.~ <br />°~ <br /> <br />ba <br />~98 ~O <br />41 <br /> <br /> <br />1 Type 5 <br />~ <br />°u ~f~Y ROAD 33A ^ Registered ~rtified ~ <br /> <br />ryii PO BOX 31300 <br />SAT ~~ CO ~~ ~ <br />^ Express M ' S ^ Insured .~ <br /> <br />° ^ Retum R t for i ^ COD <br />c 7. Date of el' e ~ <br /> <br />~ o l ti ~ ;. <br /> Re ~ dot <br />5. requested ~ <br />8. Addres ~e~'s AddreSya On <br />w ~ ~ <br />and lee}s~paid)` i <br /> \ <br />~ <br /> <br />~ .Signature: (Addressee or Agent) - <br />A <br />~ PS Form 3811, December 1994 Domestic Return Receipt <br /> <br />c <br />?~ Z 191 SSq~ 520 ESG <br />~,+- US Postal service FF~ro <br />~ Receipt for C~~igd A~ailA~ 9~ <br />No Insurance Coverage Provided~- <br />~ = Do not use for Intamafional Mail lSee reverse) <br />~ ' c PAT TEIlIl'A - <br />~ ~ 23305 BOUTr OOUN[Y ROAD 33A <br />= PO BOX 31300 <br />~ P SIBAbIBOAT SPRII~03 0080181 <br />Fas+.ga j CSC <br />n Certified Fea S <br />V Spedal Delivery Fee <br />2 AesfiCetl De97ery Fee <br />Rehm Receipt SMe41p m <br />DEC ' 2 <br />o. <br />