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I <br />G <br />RECEIPT FOR .CERTIFIED "ML-30(r ( <br />CC STREET AND ND• � � <br />P��D 21P CODE 5/� <br />T—; c•/ V �A CaOP� <br />_ ZONAL SERVICES POR AODITIONQ FEES <br />�+ 1. Shswi to whom and data delladdressee <br />nd .........,, 650 <br />RETURN' With delivery to addressee poly .....ed .. 65f <br />G RECEIPT 2• Shows to whom, date and whoa dalivand .. 35e <br />SERVICES with delivery to addressee only ...... I..... 650 <br />• DELIVER TO ADDRESSEE ONLY ...................................................... nut <br />0 SPECIAL OELIVENY (extra fas require •......... <br />�I PS Form 3800 NO INSURANCE COVERAGE PROVIDED— (Sea other side) <br />Apr. 1971 NOT FOR INTERNATIONAL MAIL a cPO: Ions O - e51-04 <br />fI' <br />ffi <br />i <br />SENDER Complete Items I, 2, and 7. <br />Add your address in the "RETURN TO" soitj on <br />rcvetz. <br />I. The fol wing service is requested (check one). <br />ow to whom and date delivered... <br />❑ Show to whom, date, and address of delivery. ._0 <br />I] RESTRICTED DELIVERY <br />Show to whom and date delivered... ...._q <br />RESTRICTED DELIVERY. <br />Show to whom, date, and address of deliye. <br />(CONSULT POSTMASTER FOR FF.kkrr) SI <br />3. A(ITIC.LE ADDRESSED 0 <br />10.2 <br />(i8 o,L o <br />3. ARTICLE DESCRIPTION: <br />REGISTERED NO. CERTIFIED NO. INSURED NO. <br />1 IAlwaya able, -IW e e of eddrwn m aprad <br />! 1 have received the article described above. <br />SIGNATURE ❑ Addre Authorized agent <br />I _ <br />{ DATE OF DELIVERY <br />POIWAAft <br />i <br />s <br />a <br />C' S. ADDRESS (Complete only it requested) <br />f <br />0 <br />6. UNABLE TO DELIVER BECAUSE: <br />CLERK'S <br />INITIALS <br />L <br />'l <br />