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2009-05-27_REVISION - C1981048
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2009-05-27_REVISION - C1981048
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Entry Properties
Last modified
8/24/2016 3:46:58 PM
Creation date
5/28/2009 3:21:31 PM
Metadata
Fields
Template:
DRMS Permit Index
Permit No
C1981048
IBM Index Class Name
REVISION
Doc Date
5/27/2009
Doc Name
Certified Return Receipts (Termination of Jurisdiction)
From
Landowners
To
DRMS
Type & Sequence
SL6
Email Name
KAG
Media Type
D
Archive
No
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¦ Complete items 1, 2, and 3. Also complete <br />item 4 if Restricted Delivery is desired. <br />¦ Print your name and address on the reverse <br />so that we can return the card to you. <br />¦ Attach this card to the back of the mailpiece, <br />or on the front if space permits. <br />1. Article Addressed to: <br /> <br />? Agent <br />Addressee <br />by (Prigted Name) C. Date of Delivery <br />A. <br />D. Is delivery address different from item 1? Ll Yes <br />If YES, enter delivery address below: 9 No <br />Bryan J. Anderson <br />#225 132-250 Shawville Blvd SE - !, <br />ice Type <br />Calgary AB-T2Y 2Z7 Canada 00000-0000 <br />ertified Mail El Express Mail <br />legistered O Return Receipt for Merchandise <br />Li Insured Mail ? C.O:D,; <br />4. Restricted Delivery? (Extra Fee) ? Yes <br />2. Article Number 7006 3450 0000 4880 0759 <br />(Transfer from service lab <br />PS Form 3811, February 2004 Domestic Return Receipt 102595-02-M-1540 <br />1 <br />¦ Complete items 1, 2, and 3. Also complete <br />item 4 if Restricted Delivery is desired. <br />¦ Print your name and address on the reverse <br />so that we can return the cans to you. <br />¦ Attach this card to the back of the mailpiece, <br />or on the front if space permits. <br />1. Article Addressed to: <br />Robert L & Grace M Morina <br />P.O. Box 301 <br />A Gardiner, NY 12525 <br />A. Signa r <br />X ? Agent <br />? Addressee <br />B. Received by (Printed ame) C. Date of Delivery <br />I' = boa S <br />D. Is delivery address different from item 1? ? Yes <br />If YES, enter delivery address below: ? No <br />3 Service Type <br />enified Mail ? Express Mail <br />? egistered ? Return Receipt for Merchandise <br />? Insured Mail ? C.O.D. <br />4. Restricted Delivery? (Extra Fee) <br />? Yes <br />(Transfer from service label) <br />7003 168D 0000 6431 4542 <br />PS Form 3811, February 2004 Domestic Return Receipt 102595-02-M-1540
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