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w SENDER: Complete Items 1,2,and 3. H r SENDER- ->mplete items 1,2,and 3 <br /> o Add your address in the"RET O"space on o d your address m the"RE N TO"space on <br /> reverse <br /> 3 averse <br /> The fglraw-ing service is requested(check one.) I. The following servue Is requested (check one) <br /> EI—Show to whom and date delivered............_Q n Show to whom and date delivered _ <br /> ❑ Show to whom,date and address oiddirery..__` ff Show to whom,date,and address of delivery _,¢ <br /> so ❑ RESTRICTED DELIVERY RESTRICTED DELIVERY <br /> Show to whom and date delivered............ ¢RESTRICTED DELIVERY. Show to whom and date delivered. .. <br /> ❑ <br /> Show to whom,date,and address of delivery.$_ RESTRICTED DELIVERY.Show to whom,date,and address of delivery.I6_ <br /> (CONSULT POSTMASTER FOR FEES) —�` (CONSULT POSTMASTER FOR FEES) <br /> 2 ARTICLE A RESSED TO: 2. ARTICLE ADDRESSED TO: <br /> rn <br /> ter 3. ARTICLE DESCRIPTION: M <br /> REGISTERED f30• CERTIFIED NO. I INSURED Z 3. ARTICLE DESCRIPTION: <br /> NO. x <br /> 1 <br /> 0REGISTERED NO. CERTIFIED NO. INSURED NO. <br /> m - a <br /> ® (Always obtain sognatrure of addressee or agent) (Aiwa obtain:i <br /> I have received the article described above. I Y' signature of addressee or agent) <br /> ar :•,:: ;.•>, I have received the article described above. <br /> ro SIGNATURE L�Addressee OAuthorized -yi SIGNATURE <br /> /J ////y��/E/p_[ m RE ❑ Addressee ❑ Authorized agent <br /> C4' I 1�--' <br /> GAS C POSTMARK H DATE OF DELIVERY POSTMARK <br /> vS ADDRESS(C�Llv <br /> ntpfete only if �� Z 5 ADDRESS (Complete only if requested) <br /> 0 �" v <br /> In <br /> y v� m <br /> 7! � <br /> 0 6. UNABLE TO DELIVER BECAUS � RX S m 6 UNABLE TO DELIVER BECAUSE: CLERK'S <br /> ITIALSO INITIALS <br /> 3 <br /> D <br /> *GPO:1979-258848 <br /> -_ �..•-•�; _ '•.a {T GPO: 1978-272-362 <br /> _.._.„_ .,�" - - - _ - - �'•- - -.__ _ .- •- - _..��-s.z-��c-e.<�tk�a�•s-..�n-i�e i�`s�ic.e et+..-�+:..-w.�•:�iii�._ <br /> y O SENDER. Complete items 1,2,and 3. ccnn %NDER. Complete items 1,2,and 3. <br /> Add your address in the"RETURN TO"space on o ° Add your address in the"RETURN TO"spac <br /> e on q <br /> 3 reverse - - _ revc.se. �} <br /> i The following service is requested (che(k one). � 1. The following service is requested(check one. <br /> n Show to whom and date delivered Show to whom and date deltvered............ . <br /> —¢ ❑ Show to whom,date and address of delivery..._a ! <br /> Show to whom,date,and address of delivery ¢ <br /> RESTRICTED DELIVERY i, ❑ RESTRICTED DELIVERY <br /> _¢ -47 Show to whom and date delivered. . . " Show to whom and date delivered............ <br /> ❑ RESTRir'TED DELIVERY, j <br /> RESTRICTED DELIVERY. Show to whom,date,and address of delivery.$_ <br /> Show to whom,date,and address of delivery $_ <br /> (CONSULT POSTMASTER FOR FEES) (CONSULT POSTMASTE2FORFEES)- <br /> 2 ARTICLE ADDRESSED TO: -i 2. ARTICLE <br /> RL'L'SEC OSs): <br /> m V % <br /> y C <br /> Z <br /> C 3r <br /> Z nt 3. ARTICLE DESCRIPTION: <br /> 3 ARTICLE DESCRIPTION: A <br /> A m REGISTERED NO. CERTIFIED NO. rf REL3 Na ., <br /> m REGISTERED NO VCERTIFIED NO. INSURED NO. 'n , 9k <br /> Ln <br /> 6mi (Always ct ti,,n tignature of addressee or a*nt1 <br /> m i (Always obtain signature of addressee or agent) in <br /> yI have received the article described above. m I havo received the article described above. <br /> mPDAT�E <br /> Addressee ❑ uthorized agent m SIGNATUPE ClAddresses OAuthorizede$errl� ( , <br /> OfAEC4. <br /> Ch VERY �p D.�TECF ELIVEm 1980 <br /> ,� a <br /> 2 5. ADDRESS (Complete only if request d) ,/y�/'J 0 5- A:.v ESS(Carte onty H ) <br /> cli <br /> � � H <br /> T 6 UNABLE TO DELIVER BECAUSE: ( K' r; G. UNABLE TO DELIVER BECAUSE: CLERKS <br /> m <br /> INITIA� ,-•:_; O IIttTIAt.S <br /> GPO•1979 2S3 848 <br />