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I , <br />L_J <br />~~ <br />• <br />$ <br />v SENDER: <br />.Compere nem. 1 anaor 2 t« edNIWrW earvirae. I also wish to receive the <br /> <br />g B9rVlt,`B8 (fof 8<I <br />1dlOwin <br />e •COmdetO name 3, 4e, erM /b. <br />a PdM your name end addmea an su rwarea al this farm so that we ran slum W s eXtra 198): <br />~ •Aaechtoth~a %orm to the boM or ttm meildem, «m Vta betlcrf apace does rat 1. ^ Addr95se9'S Address 2 <br />~ <br />o pertnn. <br />•WnteWeium Receipt Regwaretl'an the mellpleoa below tluertitle number <br />2.^R95tricled D9liVery d <br />qJ <br />$ .The Retum Receipt will show to wtnm the eNtle was tlelivem0 end the date <br />DOnsul[ pOS11T19519r IOr f99. a <br />~ delivered m <br />v 3. Arficle Addresse to: 48. ArfiGe Number <br />~ 4'~~/ 4rf'~ O <br />d ~ 3a E <br />a <br />E 4b. Service Type ~ <br /> <br />~ / <br />/)., -may f/] <br />I <br />N <br />' <br />J <br />l _d <br />P <br />^ Registered ^ Certified <br />~ <br /> I <br />( <br />, <br />O I~ <br />o ^ Ex ^ Insured q <br /> /'~ <br />~`/~G~i1((7 ^ eN dice ^ COD ~ <br /> ~ <br />G 6G~ <br /> ~ <br />N <br />i. <br /> 5. Received By: (Print Name) 8. a Ad Only it requested <br />2 ~ <br /> pa 0 <br />~ <br />N ~ <br /> liO <br />~ 6. Signature: (Addressee or Agent <br />r x <br /> - ~ - -------~-- n.........e.. o.,....., o~...e:... <br />N <br />V <br />m <br />d <br />Y <br />L <br />t <br />0 <br />d <br />a <br />E <br />w <br />0 <br />9 <br />0 <br />r <br />a <br />ti <br />d <br />v <br />m <br />a <br />w` <br />Y <br />O <br />0 <br />Y <br />m <br />c <br />E <br />0 <br />u <br />0 <br />.o•ucn. <br />Complete Gems 1 enaor 2 for addNOrW 6ervims. 1 els0 Wlsh t0 rBCdVe the <br />•Complete items 3, be, ana bb. IOIIOWing a9rvICBS (IOr 8r1 <br />• Pnnl your name ana address an the reverse of this brm w that we can velum 1Ns extra lee): <br />mra to you. O <br />Y <br />•Attach this form to fha front o11he mdtdem, or on the bads it space does not t , ^ Addressee's Address <br />" <br />eWn a <br />Aefum Recei rR uesred'on the mail ace below the aniGe number. <br />~ <br />x <br />d <br />2. ^ Restricted Delivery m <br />y <br />Bl <br />eThe Relum Receipt <br />ow to wlpm Bte art <br />e waa delivered end the Gale <br />deeverea. Consult prutrnester for fee ~ <br />~~ ~ ~~ <br />Cc~ ~~ Pa~-~r5 <br />~o ~, rp ~ s~~,~t <br />~ -3 ~ ~, S k en~ia-~ -~ <br />or <br /> <br />4a. ArOCIe Number g <br /> <br />4b. Service Type <br />^ Registered ^ Cerfified <br />^ Express Mail ^ Insuretl <br />c <br />~ <br /> <br />^ Retum Receipt for Merchandise ^ COD m <br />7. Date of Delivery F <br /> 0 <br /> r <br />8. Addressee's Address (Onlyi/requested ~ <br />and !ee is paid) <br /> <br />•Camplele items 1 anaor 2lor eddidorW eervims. <br />• Comdata earns 3. be, end bb. <br />• PnM your name end address on the revane 01 this Mnn W But we <br />cartl to you. <br />•Meth etis lolm to the front «the rnaildece, or on Ba baCk'd seam <br />pemul. <br />• Wnte'Rerum Receipt Requested' an the mailpiam below the eaitle <br />•The Relum Receld will arrow to whom the enitle wee delivered end <br />tlelrvared. <br />~~N Sty,. 1`~ <br />o ~a~ ~a~ <br />s~l(aPa cv ~~ad <br />5. Re eived By: (Prin/t Name ~!J <br />6. Signature; (Add ee~r ant) <br />x~~-~r~ <br />PS Fprrn 3811, December 1994 <br />1 also wish 1o receive the <br /> following services (for an <br />Can return Ihis 9%tfa lee): <br /> <br />goes not <br />t, ^ Addressee's Address ai <br /> <br />Z <br />number. p, ^ Restricted Delivery N <br />the date <br />Consult posbnaster for fee. <br /> ~ <br />4a. Arficle Number ~' <br />Q~j? <br />y3s <br />Z ~o '~ <br />j <br />~ <br />4b. Service Type <br />m <br />^ Registered ~, Certified <br />^ Express Mail ^ Insured c <br />^ Return Receipt for Merlitertdise ^ D <br />7. Date~f <br />eliv ry S <br />~ <br />~ 0 <br /> >A <br />B. Adtlressee s Address (Only if requested ~ <br />and fee is paid) t <br /> r- <br />m2595-9I~B-0P9 <br /> <br /> <br />