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d SENDER• <br />o .Compete <br />n .Compete <br />u •PrirH YOUr <br />e <br />~ Wrtl to ya <br />•Nleoh lhi <br />~ pennil. <br />e .Wdre'Aerum Hec.iipr Regaesrac <br /> .lhe Return Receiq show to' <br />C. <br />O deliveretl. <br />~ 3. Arficle Addressed to: <br /> <br />~' • <br /> <br /> <br />5. Received B : (Pdn! Name <br />~ 6. Signatur . (A or <br />r X <br /> <br />le mailpiece bebw theanide reaMer. 2.^Restdcted Delivery y <br />Me snide was tleevered end the dale <br />~ ~ <br />PS Form 3617, [)ecember <br />Z 4L6 942 654 <br />Receipt ~Pe„ ~~ <br />Certified aigyy{{ ~~ ~y1~°yb-sa <br />~ No Insurance f~rlEje id~/oZ"ed `--~ <br />,q.eyn`oe Do not use for International Mail <br />ISee Reverse) <br />5 r ro , <br />r <br />Sve antl No ~ <br />b ~ 73 Avw <br />P D $lale nn0 ZIP COtle c y/ <br />PDSlage Q ~ <br />Cerl,lietl F¢¢ <br />Sgncml Den.ery Fee <br />O ~e <br />flesrt¢rer Oenmrv Fee <br />W -~ <br />Fewrn ReceiPl Snowing ( , (SI <br />ro Wnom g Dare Delmere0 Z <br />I <br />flewrn Rece~or Snowing m WL !~ P` ~ <br />Dare, antl Atltlressee s Atltlresa <br />TOTAL PgsNge r ~ <br />8 Fees ~ ~~ ~ ~ <br />POSITdrk Qr•' ' T <br />c6~ <br />r'. N~ `~ J <br />~^ N <br />\,'Nl S o <br />w <br />~i <br />e <br />IL <br />items 1 end'or 21or adtitiartY eerv+cw. I also wish t0 feCelve ih0 <br />item9 3, da, and 4b. Idbwfrg s0fVIC0S (fOr an <br />name and eddrese on the reverse of ttia lornt eo Brt wa rrr return the elAra 100): <br />u. <br />form to (ho hob of the mailprew, or m the beds it apace dose nd e <br />t. ^ Addressee's Address <br />vrill <br />~cbaa <br /> Consult postmaster for tae. <br /> <br />4a. ArGCIe Number <br />z w~ 9ya ~sy <br />~ <br />4b. Service Type - ~ <br />^ Registered 8 Certified ~ <br />^ Express Mail ^ Ins~'ed <br />^ Return Receipt for Merchandise ^ COD <br /> ~ <br />elivery <br />7. Date of <br />D <br />~ <br />~` <br />C~ <br />('I5 -L~ T <br /> <br />B. Addressee's Address (Only i/requested ~ <br />end !ee is paid) i <br /> r <br />••'. 4L6 942 65~ <br />.s+' NpU <br />Rec 1 t f r j_ g~ q~S`t <br />Cert `C7 <br />- No Insurance Coverage Provide <br />e~ Do not use for International MaF~ <br />ISee Reverse) r <br />R <br />L <br />.~ <br />LL <br />a <br />Senr ro <br />~ - <br />$Ireel tl NO <br />C <br />P SNIe antl 21P Coee <br />n , <br />W cN~~ <br />Ss~ <br />Posbge <br /> <br />Cendmtl Fee - VOS <br />Soec,al Debrerv Fee 9B <br />flesvmretl Dee~.ery Fce <br />Pelmn fleceiPr Snowing <br /> <br />ro WM1Om 8 Dare Del,veretl r <br />Peturn Receigr 5 nom` <br />Dare. antl A e ee <br />TOTAL Posry~ <br />g F <br />y/ <br />ees <br />Poslmarkp Dal¢ . <br />nr, <br />' <br />~, ~C_r, tr <br />~, <br />/ .~ <br />~ <br />I _ US P0, <br />3 <br /> <br />CD <br />C <br />O <br />r° <br />0 <br />w <br />