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O <br />� <br />z <br />� <br />� <br />(U) Sili3S'I'ITUTE PL•'RSONAL S�RVIC� <br />By dclivcring and lcaiving said copy with Lhc follo�ving <br />• :a,...,:r.,..i :...�:..:.i,..i .. ...._...... ..� ........i.�,, agc.��iid dis- . <br />RECEIPT FOR CERTIFIED MAIL-30F i�vncr(s) tisual <br />srnito I ro;rM.nn �127CIO�V: <br />i. n � C NRs ,�'r9 �" �"„ <br />srnu*.noao. <br />9Eio i9v °� �� <br />r o., srerE,.�+o zircooE <br />snu hb.,,s tt �/n/ <br />EfIN1 SCRYICCS IOA �OOI110Nq <br />R�lum P�p101 <br />sno�.��,.�nom sn.,w.ro��r��m, <br />ndJntr ,Inn�. ndrchrrr <br />J,�In-rred dN�rere�d <br />❑ 10f lco ❑ 35( /ea <br />fODform3800 MO INSUR�NCE COVCq� <br />Ma�. I%6 NDT fOR IMTERH�TI <br />Datc Scrvc�d <br />M <br />� . ..,, .. ,. ,. . . <br />9F290 „ ' <br />r[[s � + ' <br />ONn�rm � <br />Addrner� OnIY ��-) <br />❑ SOf Iee � <br />:E PHOVIOFO— (Sce ofher side) � <br />IN111 M�IL , <br />. • , • ... ' , • (c)' SF_P.VIGE 13"�\Q!lIL .. - • . <br />}3�> dcpnsitin� in the mails of ll�e United States by regis.ercd <br />mail or ccr.i:icd mail a u,-operl� :;;ampcu and adtiressed <br />envclopc containing said copy di:ccted to said owner(s) <br />addressed and on tl�c dat. set f�rth hercinbclow: <br />Ormcr I�ame Mail Address Datc Mai7.ed <br />Robert Cliaska 4610 144t1i Drive, Sneliomish, Wn. J�� /� / 97> <br />.�� �. �� , <br />, <br />SUPSC22I73P:D r�A'D S1'i OF.A' to Uciorc me tl�is J� day of � Z,� % ��f , 19 ? 7 <br />� <br />tENDER:M�mM}d1s�rl�dr�N!en���efienide 'A�Zy PUliLIG in and Ior Lhe Siate <br />pLEASE FURNISN SERVICE(S) INWCATED BY CHECKED BLOCK(S) -ashington, residing in <br />IAddCioiwl ehnrpn rcOwittd 1or IAn� urokeA <br />r—i Show address n Ddiver ONLY <br />A�telred IAe ���itnd �MINe detcdied id�w . <br />