REP23652

• Permit No: M1977132
• IBM Index Class Name: Report
• Doc Date: 1/17/1995
• Doc Name: RECEIPT
• From: WENDY SANDOVAL
• To: CLAIRE L HORVELY
• Permit Index Doc Type: ANNUAL FEE / REPORT
• Media Type: D
• Archive: No

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SENDER: Complete Items 1, 2, 3 and 4.
Pur your atltlrass in the "RETURN TO" space on the
^"arse sitle. Failure to do this will prevent th is cartl from
ng returnetl to ypu. The return receipt fee will prpvid!
~ the name of the person tleliveretl to antl the pate O~
tlelivery. For etltlitional teas the following services era
available. Consult postmsster }or teas entl check boxles)
for serv icalsl requested.
1. ~ Show to whom, data eno aooress of Delivery. .
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Z. ^ Restrictetl Delivery.
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4. Type
at Service: Ar[~cle Number
^ Registered ^ Insured
~Certltled ^ coo X105? Tc'7(, 10(0
Express Mall
Always obtain signature of addressee or agent and
DATE DELIVERED.
5. Sign r - Atltlrassea
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6. Signature -Agent- r„r `~
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Date of Delive y ., ~(' 'I'mo ,

8. Addressee's AO rgss (OA'L•Y ijr erteQa ee Pg

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P 652 676 106
RECEIPT FOR CERTIFIED MAIL
NO INSURANCE COVERAGE PROVIDED
NOT FOR INTERNATIONAL MAIL
-'~.~ ~ ~7 (See Reverse/
S~¢t t ^
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et entl No.
P.O., State and ZIP Cotle
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Postage S
Cenlfled Fee
Special Delivery Fee
Restricted Delivery Fee
Return Receipt Snowing -+ .
to whom and Date Delivered
Return receipt stwwing to whom,
Date, and Adtlress of Dalive7__

TOTAL Postage and'F~ee~ ~
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