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m SENDER: I also wish to receive the <br /> a .Complete items f anNor 2 for additional services, following services for an <br /> Ts •Congbte items 3,4e,and 4b. g <br /> •Print your name and address on the vverse of this form so met we can return this extra fee): <br /> card to vyou. <br /> 0 ■Attach l9s form to the front of dre maiyieco,or on the beck it space does not 1.0 Addressee's Address <br /> ` Write'pe nY. <br /> . Karam Receipt Requested'at the h article w sbelowdeli me grand number. 2.O Restricted Delivery <br /> yQ •The Return Receipt will show fo whom me article was delivered and the date Consult postmaster for fee. _ <br /> Delivered. po G <br /> 3.Article Addressed to: 4a.Article Number I <br /> y . b 90� tmine� 0 1670 g�tf- e <br /> Ey�,�( /v2� � 4b.Service Type <br /> 3 ROC <br /> rl ALA- J � ❑ Registered '�WCenified <br /> (? © �0-?c 0 Express Mail ❑ Insured <br /> ❑ Return Receipt for Merchandise ❑ COD :2 <br /> n 7.Date of Delivery <br /> LA <br /> j <br /> O R�; <br /> 5.Received By: (Print Name) 8,Addressee's Address(Only if requested Y <br /> and!as is paid) <br /> _8 sia a re /Add cc�1 of A t) <br /> 0 <br /> T <br /> urn Receipt <br /> I also wish to receive the <br /> aconplae hems f andfor 2 for edditWW service". following services(for an <br /> a acomplsts hem,3,as,and 4b.4 .prkt yw nar,*wW ad*m on the Miens of er extra f66):,dorm so that we can return this a <br /> iL ward to you. <br /> •/,tech thattorn to the front of the M011 ieca,wan the bark ff,pam does not 1.O Addr8556e's Address <br /> o sw�i Return Receipt Requesfad,m the m iilpi,ce below the article number. 2.0 Restricted Delivery W <br /> fi aThe Relum R,capt roll show to wtpm Ua article was delivered and the date Consult postmaster for fee. <br /> C delivered. <br /> 0 y 3.Article Addressed to: 4a.Article Number <br /> S9 z s� 33 t <br /> 0 __ - 4b.Service Type <br /> Ms Jackie Goemmer ❑ Registered �kCernfisd a <br /> PO Box 165 ❑ Express Mail ❑ insured <br /> LaVeta CO 81055 ❑ Rettu&raosiptiorMerchandise 0 COD <br /> `o <br /> 7.Date Deliveryy , .1 n <br /> r <br /> 8. asee's Addre my if requested <br /> 5.Received By:(Print Name) ge is - F <br /> g 6.Sign!a, A s e DO d <br /> i X <br /> = PS Fam 3ii 1. eerlrr Der 1 1029ew44oe79 411111111111 <br /> ltC Retum Receipt <br /> �11GG8 05 JBAUa(7 rS1Z ' `UEU112 — <br /> �S s[e[ ncl <br /> m D <br /> rruuIz <br /> g <br /> fTim m o E <br /> m'm E ss gv <br /> rLk'1 <br /> 4j1 <br /> Z w O LL y 9r m u <br /> (rj M U U m .055 0 ON 8, N O <br /> Co <br /> n.t <br /> m 4) o —r0i m m PP� mmQq yT1i ;Es <br /> N 7tt2o'i• L1. .-a o. Cl r7f d dda a <br /> 9661.IIJdV'008C LWozi Sol <br />