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a <br />No. <br />. SENDER: CoInPMN Rrm. 1, 3, and a. <br />Add "RETURN <br />your address In Ns To" W o, m <br />resar i <br />M <br />_ <br />I. The f9Pwing service is requested (check one). <br />RECEIPT FOR CERTIFIED MAIL <br />i <br />w to whom and date delivered. ......... � <br />Show to whom, due, and address of delive <br />NO INSURANCE COVERAGE PROVIDED — <br />NOT FOR INTERNATIONAL MAIL <br />at <br />RESTRICTED DELIVERY <br />(See Reverse) <br />Show o whom and date delivered.......... <br />S€UT F , <br />L <br />RESTRICTED DELIVERY, <br />Slow to whom, date• and address of delivery. S— <br />sTREETAND ND. <br />ypel j"l� <br />(CONSULT POSTMASTER FOR FEES) <br />P.CCETATE All IS COD9 5�11 <br />a. ARTICI[110DI1 It 70:. POSTAGE $ <br />C• AL'/L!� CERTIFIED FEE <br />/�V— SPECIAL DELIVERY a <br />RESTRICTED DELIVERY It <br />f. ARTICIf ObCRIrfION: <br />� <br />S DO IDIOM ARO DATE <br />REGISTERED NO. <br />CENTIFIED NO. <br />INSURED ND. <br />}IE�CEE <br />F <br />' <br />OWDRED <br />a <br />Wo 9/9 <br />"SHN H <br />AND <br />r IAIINaFSAiRMtsawaaNaaYra anRl <br />p� <br />i <br />6 <br />W <br />ADDRESS IX IXIMRY4 <br />T <br />I have received the article described above. <br />y <br />2 <br />SHOW TD WHOM AND DATE <br />SIGNATURE 13 Addressee ❑ Authorized <br />z <br />NLKDD WITH RESTRICTED <br />agrat <br />177ff <br />z <br />DRMRv <br />a. <br />DATC OF DEIIYERT <br />S. ADDRESS (Cemagn MIF <br />CiOfYADDRESS WHOM. BAR <br />NM <br />as RESERVED NImRN t <br />m TOTAL POSTAGE AND FEES <br />`a AflK OR DATE <br />sr <br />tr <br />