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III IIIIIIIIIIIII III <br />999 <br />.SENDER: Complete Items 1 end 2 when adtlltlonel servlcea ere tleslretl, end complete Items 9 <br />end 4. <br />Put your address In the "RETURN TO" Space on the reverse sltle. Failure to do this will prevent this <br />card from beln9 returned to you. The re[urn recelot fee will grovltle you the name of the parson <br />tlellvered to end the date of tlellverv. For additional fees the following servlen ere available. Consult <br />poftmaster for fees entl check boxla) for stldltlonel service(s) requested. <br />1. ^ Snow to whom delivered, date, entl addressee's eddrao. ]. ^ Restricted Dellvary <br />1 (Extra charge/ 1 t (Extra charge) t <br />3. Article Addressed to: <br />~I r {~~ 4. Article Number <br />~ ~ r~ ~ G? <br />/ <br />`f'Lci. tit ~ "`e-~ ~ ~i1 Type of Service: <br />~l~~ ~ W,/ ;/ <br />~ <br />~ l ~' ~ ^ Regictered ^ Irnured <br />~Cartifled ^ COD <br />Y <br />/ ~ <br />r ~h la ^ Express Mail <br />pL <br />C - c; ~ ~ 7 '~ <br />.~-^~ C~„-k J Always obtain signature of addressee <br />or agent and DATE DELIVERED. <br />5. Signature -Addressee <br />x 8. Addressee's Addresc (ONLY if <br />requested and fee paid) <br />8. Signature -Agent <br />x <br />7. Date of Delivery <br />PS Form 3891, Mar. 7987 w U.S.tL-O. 1997-17&RfiB <br />P 860 179 212 <br />~~~vQiYi~d Ndaii C~~eei~4 <br />No Insurance Coverage Provided <br />o Do not use for International Mail <br />~,o,o (See Reverse), _ b„7 r <br />Sant to / <br />_' I~ $ <br />Street <br />6 <br />No <br />/ <br />~ <br />V /~ <br />P.O., Slate 6 21P Code <br /> cc ` <br />O COv77 <br />Postage ~y <br />T <br /> <br />Cen~fbtl Fee <br />V <br />Special Dellvary fee <br />Resmtlee Delivery Fee <br />Relum Receipt Showing <br />b Whom 6 Date Dalrvered <br /> <br />Return Receipt Shvw~ng b Whom, <br />Deb. 6 Address al Delivery <br />TOTAL Fbstage ~i <br />a Fees V~ <br />Postmark or Deb <br />O <br />T <br />Ql <br />C <br />O <br />0 <br />m <br />E <br />s <br />a <br /> <br />w <br />w <br />S <br />N <br />w <br />3 <br />fV <br />f <br /> <br />DOMESTIC RETURN RECEIPT <br />r_yrd f Y. ~i-[_' hi~i-i`zicio y jlp ?i •..r rrn= `'_ <br />~` ~ ~ ~ I =:1~ ~ I~~f fL'I o~ <br />P 860 179 212 <br />` 'r.~ ~ 1;...-,_: _ Tel'. .~+1~ <br />