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.SENDER: Compl•t• It•m• 1 Mtl Z when rlditlond Mrvkw x• drlred, end compl•t• It•m• 3 <br />xM <br />Put your •ddI•~ In th• '• RETURN TO" Sp•c• on th• r•vrw eld•. FNlur• to do MI• wlll Drmns thl• <br />Cx0 frtxn Ging rnumw to You. <br />01 •ddltbnel M • ollowing Nrvlew •r• •vI •bl•, Con•uH <br />ptMtmeetx or •nd ph•• GOx •• for eddltienel ••rvlu(•) r•4n••tN1. <br />1. O Show to whom tlNlvx•d, d•b, end Wdre•w'• •ddr•R Z. ^ q•urlet•d D•Ilvxy <br />1/8xfn Cher(eJf t/Sxtro ch•rge)t <br />3. Artlele Addrened to: 4. Artiele NumWr <br />C <br />Q~ S y s i s <br />a>1,~Ee. <br />ti, // (~' _/~~•~!JO~t.tl`L~~ <br />~J'l o7 Jr .-d oT.f-~.~i <br />n Type rvlce: <br />~arpflW °^ )COuo <br />I~ _ (~ ( _ ~•-~ ~ US 3 ~ <br />~YJ <br />L <br />- <br />' <br />' ^ Exprep Mel) <br />.X.J <br />U <br />~ <br />,(~+ <br />LtVr Alweyr abQkl •iBnetura of addrerree <br />a agent snd DATE DELIVERED. <br />Sip tut - Addre 8, Addreu•e't Address (ONLY if <br />requested and fee paid/ <br />ure -Agent <br />X <br />7, Den of Dsli <br />.~ <br />PS FprEn 3E77r 16r. 1987 • W.QI.O. feet'-[7eaee DOMESTIC RETURN RECEIPT <br />_ ~ <ffiYw. ~ <br />r~ a 765 lien 13c ~ <br />RECEIPT FOR CERTIFIED MAIL j"- <br />r+0 R+SURAgCE C7VEPA4E PROYIOEO r <br />'At FOP ~tii ERgR~IOgRt MR~L ^' <br />ISee Reversal '-' <br />N <br />m <br />w <br />C <br />7 <br />0 <br />ct <br />E <br />LL <br />N <br />si" to ~ - <br />n <br />Slreel and r'o <br />J J <br />Pp $I le antl 21P Coa¢ ~ , < <br />O C J <br />Poslage ~ 5 <br />GerUl~ed Fee <br />r ~ <br />i <br />- <br />• _ <br />~ <br />Spew ei~~r• Fee _.:'x r. <br />li; <br />Resloci¢e De•rve~y Fee a <br />V <br />Retum Receipt ow~nq <br />to venom and Dale Delrve pvtl _ <br />•~ <br />' <br />y <br />r <br />~, <br />Return Rele~ 1 5, <br />W in to `~~( <br />`' r <br />Oale Tryst (ta[Ir4"Yd~.~q#I'~M` ~. ~,:•'~~~'• <br />! .: .,.. <br />~~ <br />TOTAL Poslage antl Fees <br />5 <br />ppstmarw m Date <br />LJ <br />-A <br />L~ <br />i0 <br />.~ <br />CL <br />nJ, <br />Y <br />..7 <br />!4 <br />7 <br />fA <br />C: <br />-] <br />+. i <br />(+ <br />