INSPEC22292

• Permit No: M1990057
• IBM Index Class Name: Inspection
• Doc Name: RECEIPT FOR CERTIFIED MAIL
• Media Type: D
• Archive: No

III IIIIIIIIIIIIIIII
999
n.
v SENDER:
'y • Complete items 1 end/or ]for atldioonal services.
y Complete items 3, and 4a 6 b.
• Print your name and adtlress on the reverse of this form so that we can
m return this card to you.
O • Attach this lorm to the Iront of [he mailpiece, or an the back it space
does not permit.
m • Witte"Return Receipt Renuesled"on the mailpiece below the article number
• The Return Receipt will show to whom the article was deliveretl and [he date
I also wish to receive the
following services Ifor an extra
feel:
1. ^ Addressee's Address
2. ^ Restricted Delivery
G deLveretl. CODSUIt
v
m 3. Article Addressed to' 4 Article Numb

p ~7~dp ~~l/~_~y,~,,~•
" ~~"~• ~~~ ~ ~ /
y 46. Service Type
^ Registered
~
~
~~~ C~v L
~rtified
N
w
2 ,
y `
~'S ^ Express Mall

~
O `7µ'C
J ~-lJ
W
7. Date of Delive
Q
Z 5
K
7
f _
~ 6.
O
n p<
Signature (Agent)
8.
and fee is paid)
^ Insured
m
U
.'
0
N
6
.0
U
Q
e
w
^ COD 5
^ Return Receipt for ~
Merchandise
/ ~.
0
(Only If requested Y 1
C
m
L
H
Form 11, December 1991 aU.S.GP0:1laYY~31fp DOMESTIC RETURN RECEIPT
P• 296 ~6~~D.768r,~_S
N ~ C~tIT~U~Nt~~-~~i"i~.
No Insurance Coverage Provided
~ ~r~jy0.« Do not use for International Mail
ISee Raver e)
V
m
Y
C
0
T
N
G
5 m io OK~
Heel and No
P 5 ale and ZIP C e
Pomaye
a
Ceiblietl Fee
Sueera' Deln=rv Fee
Resv¢letl Dolrvew Fes
Re~wn Recemi SM1Owiny
to WM1Om B Dare Delivered
Pemm Receioi $nowng ~o Wnom,
Dale, an0 Atld~e53Pe 5 4dd~ess
iOiAL Postage
Fees a
PDSImd~V. or Date
• • s • - • ~
• .•
~ .
P 296 602 768
•r