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REP22677
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REP22677
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Entry Properties
Last modified
8/24/2016 11:55:25 PM
Creation date
11/27/2007 3:31:04 AM
Metadata
Fields
Template:
DRMS Permit Index
Permit No
M1980047
IBM Index Class Name
Report
Doc Date
12/3/1987
Permit Index Doc Type
ANNUAL FEE / REPORT
Media Type
D
Archive
No
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<br />•SENDE R: Complete Items 1 antl Z when sdditlonel services are dwiretl, end complete items 3 <br />antl 4. <br />Put your address in <he "RET V RN TO" Space on the reverse side. Fellura to do this will prevent thls <br />eerd tram beln9 retu rnetl to you. The return recalot fee wlll provide you the name of the oanon <br />Callvaratl to end the tlete o1 tleliverv. For etldltlonal teas the followlnB servlcas ere evelleble. Consult <br />Postmaster for fa96 and check box(es) for etltlitlonal serulce(sl requested. <br />1. ^ Show to whom tleliveratl, tlete, end addressee's etldress. 2. ^ Ras[rictetl Delivery <br />i (Extra charge) t =1 /Exda cfiargeJ t <br />3. Article Addressed to: 4. Article Number <br />~t-'L~~~ ~ U ~ d~ LAS ! 6 7 t/ 5 ~' ~, <br />Type of Service: <br />~~ ~ ~~ ^ Registered ^ Insured <br />Certified ^ COD <br />s _ Express M it <br />c i <br />L,/`,+'w'"~ / ~~'rt • f L~~ O ~ ~~ L- z- Always obta"m signature of edtlressee <br />or agent and DATE DELIVERED. <br />5. Signature -Addressee 8. Addressee's Address IONL Y if <br />X requested and fee paid) <br />6. Signature - A~ <br />X <br />7. Date of Del ~ ~~~ <br />PS Form 3611, Mar. 1987 t U.S.G.P.O. 199]-170-469 <br />P 051 874 586 <br />RECEIPT FOR CERTIFIED MAIL <br />NO INSURANCE COVERAGE PROVIDED <br />NOT FOR INTERNATIONAL MAIL <br />n ~= (See Reverse) ,, , „ _ <br />DOMESTIC RETURN <br />pp~ Sent to <br />ap i <br />Street and No. <br />P.O., State and ZIP Cotle ~` ~ <br />i .,,, _ <br />~ ~ ("~ l St7 `^ <br />y Postage ~ S .~ <br />~ ro <br />• Certdietl Fae ca <br /> _,.__ ~ r , <br /> Restrlctetl Delivery Fee ,y.a <br /> Return Receipt S owing <br /> to whom antl Dat D iv ~~' <br />-i <br />~ Return rpm h ~ c3 <br />- <br /> Data, aAQ 'V~~'Q " <br />o TOTAL POSfa a '~ <br />g ~ ees a ._~ <br />U <br />LL J <br />o° Postmark or D U frt <br />j: • <br />~r ~ h <br />i c~ <br /> (_ <br />~ r~ <br />E ., ,r. <br />~ 'C, Iw <br /> I <br />N <br />d <br />
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