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.SENDER: Complete items 1 end 2 when etlditlonel servkn ere deslnd, end eompbn Items 3 <br />end 4. <br />Put your sddress In the "RETURN TO" Specs on the reverse side. Failure to tlo this will prevent this <br />card from being returned to you. The return receipt fee will orovlde you the name o1 the oerson <br />delivered to entl the date o} dellverv. For edtlltlonsl fees the following services ere available. Consult <br />pmtmester for lees end check box(es) for etldltlonel service(s) requested. <br />7. ^ Show to whom tlellvered, tlete, end etltlressae's sddreu. Z. ^ Restricted Delivery <br />t (Esrra charBeJ t 1 /Extra charge) t <br />3. ArticW Addressed to: 4. Article Number <br />9 <br />Q ~~ <br />G~ la ~ v~ o~ <br />( <br />- <br />.~ fS <br /> ervice: <br />Type o <br />l <br />° <br />~ ~ ~OS <br />~ ~/1 ( <br />' <br />x(51 <br />( <br />~ ^ Reg <br />stered ^ Insured <br />i <br />4 <br />RJ <br />l <br />- <br />, <br />,- / 'Certified ^ COD <br />/~ 1 ~OSv / ^ Express Mail <br />y. ~J Alwayc obtain signature of a~lreuee <br />r or agent end DATE DE LI V ~R E D. <br />5. Sign~~~tttyyy~~t~~~ Addrauee 8. Addressee's Address (ONL if <br />x (-' ~ Q _ <br />~ <br />' <br />T requested and fee paid/ <br />6. Sigoature <br />- <br />Agen <br />t <br />x <br />7. De aq~eliv~l~ <br />PS Form 3871, Maz. 198'1 : U.S.G.P.O. t9e7-t7&PSe DOMESTIC RETURN RECEIPT <br />P 765 475 068' <br />RECEIPT FOA CE~TIFI~D MAIL <br />NO INGOflAAiE COVERAGE PflOVIDED <br />NOr FOR INTERNATIONAL MAIL <br />/See Reverse/ <br />N <br />m <br />d <br />C <br />J <br />7 <br />O <br />E <br />0 <br />LL <br />a <br />S nt to <br />Street entl No <br />o aos <br />P.O.. State entl ZI Code <br />Co O <br />Posla 5 <br />Cenilietl Fee <br />Special Delivery Fee <br />Restnaed Delivery Fee <br />,\ <br />Return Receipt showing r <br />to whom and Dale Deliveretl <br />Return Receipt showing to whom. <br />Date. and Address of Delivery <br />TOTAL Postage entl Fees 5 <br />Postmark or Date <br />0 <br />fV <br />O <br />U <br />L <br />tv <br />C <br />N <br />r <br />N <br />E <br />C <br />E <br />L <br />C7 <br />T <br />T <br />~' <br /> <br />