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N <br />T <br />O <br />3' <br />C <br />m <br />m <br />W <br />• SENDER: Cpmpltne items 1, 2, 3 and 4. <br />Put your address in the "RETURN TO" space On the <br />reverse side. Failure to do this will prevent this cartl from <br />being returned to you. The retwn receipt lee will prpviy . <br />you the name of the person delivered to end the date OI <br />tleliverv. For additional fees Cho following Cervices era <br />available. Confult postmaster fOr fees and check f»xlasl <br />far zervicelsl requxtatl. <br />1 Show to whom, data and adtlrau of delivery. <br />Z. ~ Rrtricta0 DNivxy. <br />3.1 Articb AtldrwfW to: <br /> <br /> <br />C.~ cG ~lc~al0 <br />4. Type o/ Service: Article Number <br />Registered ~ Insured <br />Certified (] COD ~~~~ ~ ~~ ~~^ <br />Y~ <br />Express Mail <br />Always obtain signature of addressee or agent and <br />DATE DELIVERED. <br />5. Signa e - Atldressae <br />X ~ V~ <br />Signature -Agent <br />X ~ <br />7. Date of D/e/livery ^7 ~~ <br />5~ TA <br />8. Atldr¢siee's Atldress N'Y iJrpqu d ee Pg <br /> <br />~ ~ ! i <br />~~ _. / <br />a <br />3 <br />u <br />n <br />Z <br />R <br />ti <br />C <br />3 <br />2 <br />S <br />n <br />R <br />Y <br />c <br />c <br />u <br />A <br />~I <br />~a <br />~_ <br />s <br />~~ <br />~~ <br />rv/E <br />~n' <br />.r.a <br />P X68 279 549 <br />RECEIPT FOR CERTIFIED MAIL <br />NO INSUflANCE COVERAGE PROVIDED <br />NOT FOR INTERNATIONAL MAIL <br />(See Reverse) ~S2 <br />Sent to I \ <br />5 et antl N~ ~ <br /> <br />l7 K <br />0 <br />P.O., ~Ctate antl ZIP Co e <br />r <br />Postage S <br />Certified FBes <br />1 <br />1 <br />;i ~_ <br />Special Delivery Fee <br /> <br />Restrlcled Delivery Fee ~ `s' <br />Return Racegs t S~hows <br />to whom anP~(~,e4KP91f~'T~ N D '= <br />Return receipt showing to whom, r <br />Date, and Atltlress of DEliveq <br />TOTAL Postage tl~es-~- ..~, S _ <br />~ \ <br />POStmark or D t~ GA - 1 ~ <br />i <br />~ <br />~ <br />~ , ~t <br />~~~ ~~ <br />~\ <br />' <br />` a.~; <br />