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<br />m SENDER: <br />s Complete items 1 and/or 2 for etlditional services. <br />a Complete items 3, antl 4e 6 b. <br />e~j • Print yom name and address oe the reverse at th'o torm yo that we can <br />~ return this card to you. <br />~ • Attach this form tc the Iront of the mailpiece, or on the back it space <br />r does not permit. <br />L • Wrha "Retain RecaipC Raqueated' on the mailpiece below the article number <br />• The Return Receipt will ahow to whom the article was delivered end the date <br />C delivered. <br />~ 3. Article Addressed to: <br />Mr. ~ , l~iC1~(~r~eS <br />V~i-Cu ~. <br />5. Slanatu,e~l~essee~~--T-I <br />W <br />6 <br />0 <br />> . <br />8 PS <br />I also wish to receive the <br />following Services (for an extra <br />feel: <br />1.~ ^ Addressee's Address <br />2. ^ Restricted Delivery <br />4b. Service Type <br />^ Registered ^ Insured <br />Certified ^ COD <br />^ Express Mail ^ Return Receipt for <br />- n _. <br />(Agent) <br />8. Addressee's Address (Only if <br />and Tee is paid) <br />tr U.S.G.P.0.: 1992-30]-530 DOMESTIC <br />77-aj~.N7,aa 3, S59 S(c0,57,, 5~3 <br />7b•dg7 p 75~C166 325'pn <br />~.~y r3~ ~~t for <br />g,~15 ~ ~rc'T'ett-MaiF-'-. <br />N"~ No Insurance Coverage Provided <br />C~O~..~ Do not use for International Mail <br />ISee Reversal <br /> em to <br /> Snee na no <br /> .~ <br /> P $Iale n0 ?IP COtle ~/ <br /> Ova9e 1~ <br />'T <br /> Ce,ulietl Fee <br /> Special Dercerv Fee <br /> Pesmnetl Delnerv Fee <br /> Fewm aeceiOr Snowing <br /> m Wnom b Dale Dee.e~ec <br /> Fewm Pere~ol Snowing ro Whom. <br /> s 4tltlress <br />e <br />' <br />Dale, antl Atltlresse <br />CaD c <br />~ <br />~ <br />TOTAL POS QU <br /> B Fees <br /> Poslm k o <br /> ~~ b <br /> <br /> <br /> <br /> <br /> <br />0 <br />u <br />.~ <br />O <br />N <br />6 <br />"e <br />V <br />O <br />e <br />Q <br />la <br />.~ <br />r <br />O <br />e <br />a <br />F <br />