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iii iiiiiiiiiiiiiiii~ <br />999 <br /> <br />(~,P 213 351 5'0~ <br />`Po I <br />rtified Mail <br />~G. u erage Provided. <br />I IMaI S <br />7 <br />~~e <br />CC: <br />C~ <br />C <br />i <br /> <br />use ntemationa t ee reverse -+ <br /> w <br /> J <br /> w <br />S Num <br />a <br />6 r~ e o ~6 `° <br />Postega a <br />Cerctletl Fee ~ <br /> <br />Spedal Delivery Fee - . N <br /> i <br />Reslridetl Delivery F,ee <br />~ <br />~ ~ <br />R <br />Fielum Q <br />who 4,`. ~ <br />~'. mWhdn, ~ <br />asses Ad6es5 <br />ALP >r I;7 <br />t <br />I Q <br />~ P ah or Date <br />> ~ <br />.~ O <br />, <br />.. ~i? j.;.r- <br />~' SENDER: <br />v .Complete items t anNor 2 for eotli6oral services. I also wish to receive the <br />m •Camptate items 3, 4a, and bb. fdbwing Sen/iCeS (for an <br />O <br />~ •P~m your name end aotlress on me reveres of this form so mat we can return this 91(tra fBB <br />~ <br /> <br />j Wrtl la ye U. <br />•Anach mis form to the honl of the mailpiece, or on the bade if space tlcas not <br />t <br />^ Addressee's Address Y <br />~ <br />O <br />o • W 161`RBfUm Racei f R u&sfee' on the meUpiete below the aniclB number. <br />p v eQ „ <br />2. ^'Restdcted Delivery Y <br />N <br /> .The Return Receipt will show to whom the anida was tlelivered antl the Bate <br />e ~~~ Consultpostm'rs~erforfee <br />0 <br />a 3. Article Addressed to: // ~ /' <br />wen~~ C~ LOS ~ L D <br />sag5s7 ~a~ ~~K~ ~~ ~ <br />~~ CyP~/~ C'~ ~~~7 <br />z <br />5. Received By; (Print Name) <br />f- <br />W <br />6. SXnat : (Addre~e gr Agar <br />o r /~S,_y~lJ <br /> <br />4a cle Number <br />- <br />` <br />~ <br />' ~, <br />i <br />.~~D <br />~a~ 3 35 s <br />4b. Service Type ~ • y ~ <br />^ Registered ^ Certified ~ <br /> <br />^ F~rpress Mail ^ Insured m <br />e <br />^ Relum Receipt tot Merchandise ^ COD <br />7. Date of Deli /~ ~ <br />~ ~ . <br />6. Addressee's Ad <br />ss {Only it requested ~ <br />and fee is paid) ~ <br /> M <br />PS Fonn 3811, December 1994 <br />