Laserfiche WebLink
<br /> s~oen: wst,a,a.r~. <br /> Put your atldrlu in [h! "RETURN TO" w!elon Nw <br /> rlWne litM. Failure [o do N is will Drlvlnt thisexd from <br /> Wing rlturfild to YOU. The return r!tlip[ fY will Drovid! <br /> 1L~ thlnlm! of the person dNiytarld tolnd M! dst! of <br /> del- iVxy'FOfltlditipMlfw tfllfollowinp MrVkei lr/ <br />aveilldl. Conful[ postmet[!r for fw and cheek boz(wl <br /> for Nryiq(s)ragpMtld. <br /> l dMivl <br />h <br />h <br />Wtl <br /> ry. <br />rpA O <br />ow to w <br />1. S <br />om, d!U lM1 <br />5 2. ~ Rlmktld DNiylry. <br /> 3. Artkl! AddrlsNd [o: <br /> ~~ G n~ Q.Q <br /> 7A <br />(;4gr4' S y 5' S <br /> c <br />6 ~ ~ 7 <br /> 1. Typ! W Slrvirw: ArtiU! NumWr <br /> t~ f id ~ CDD <br />O Et~rasMlAl (~ <br />Y I ~~ ~D !a' <br /> ,y. lrray3 obmin siprUtull of atldnll!l9Lpr'ht uld <br /> DATE OEt.IVERED. <br /> . $tpnltur!-AddrlM! <br /> yl <br /> 8. S'gnlwn - t <br /> X QiJ/ ~ 4rq <br /> 7, OMOf ONIvlrY I,~4R ' <br /> 8. Addrlw!'! AddrNt( <br />9 ' ~O A~ <br />a 4~ <br /> .. <br /> <br />m <br />O <br />u <br />O <br />u! <br />a <br />m <br />a <br />IL <br />IL <br />ti <br />a <br />P 168 480 129 <br />RECEIPT FOR CERTIFIED MAIL <br />NO INSURANCE COVERAGE PROVIDED <br />NOT FOR INTERNATIONAL MAIL <br />~ r (See Reverse) <br />Sent to- <br />Street a No. Z/ <br />5 ~ <br />b <br />P.O., late and ZIP Code , <br />Postage S ] <br />Certified Fee <br />Special Delivery Fee <br />Restricted Delivery Fee <br />Return Receipt Showing <br />to whom antl Date Deliveretl <br />Return receipt showipp bw om, <br />Date, and Aodr of Dellve <br />TOTAL POST e,~grtd Fees Y~yS~ <br />J S <br />// t <br />Postmark ([)file' >Fo~ A ~ <br /> <br />/ <br />~. <br />. C -.. <br />.. t` <br />7y_ <br />