REP00146

• Permit No: M1978271
• IBM Index Class Name: Report
• Doc Date: 10/1/1984
• Doc Name: 112 ANNUAL FEE LETTER
• Permit Index Doc Type: ANNUAL FEE / REPORT
• Media Type: D
• Archive: No

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RECEIP7r FUR CERTIFIED MA~
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NO INSURANCE COVERAGE PROVIDED
NOT FOR INTERNATIONAL MAIL
(See Reverse) ~q_ ~~~
Sent 10
S reef and No.
P~Q., tale and ZIP Code _
Postage S
Certlfletl Fee
Special Delivery Fee
Restricted Delivery Fee
Return Receipt Showing
to whom and Date Dellveretl S
Retum receipt sho i 0 whom,
bete, and Adtlr Ilrery
TOTAL Pos Fees •~~ S
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Postmark
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SENDER: Complete items T, 2, 3 and 4.
Put your atldress in Me "RETURN TO" space on the
reverse side. Failure to d0 [his will prevent this card Irom
being returnetl to you. TTe return receipt lee will provide
~u the name el the persgn tlaliveretl to end the data of
Oelivery~ For adtliiional Ise6 Me IOIIOwinp wrvices ere
available. Consult postmaster for teas end check bo.IM)
for sarv icals) requested.
t. ®Show io whom, tlate and adtlress of delivery.
1. ^ Restrictetl Delivery.
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4. TYPe of $erv¢e: Article Number
^ Registeretl ^ Insured
Certified ^ COD n / ~~ / ~~ 33
1" C9 (o
Express Mail
Always obtain signature o1 atltlressee or agent and
DATE DELIVERED.
5. Sign je - Addressee
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6. Sr n - ggent
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). Date of Delrverv ~ ~r j "
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e. Addressee s Address (ONLY ijrequ e a Ps
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