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Cr: <br />r�� <br />M <br />� <br />� <br />RECEIP��ERTIFIE� dIAIL-301 (plus <br />stn� ro � <br />_Mr_.Sam Matsen _ — — 'I <br />sTx�[r nno no. i <br />__4412 N.E_ 60th-St= - I <br />P.o, suTe nno :ia c°ui 98115 <br />Everett, WA. -- <br />-- <br />- pP110M�1 5[RV�C[6 tON �VUIiIOMI.� fEES <br />p[TUPM' �� S�o�s te v�om anE E�te EellvertE � 65� <br />w tn aeu�e�r io aeartssee o��r <br />PU[IPT � p. SneMti lo ��sm, Eate �nE M��re EelhrrtE - B5� <br />stxvie�e w m a�i�+,�r+o eam�s:ee a�ir. .. ...: soe <br />Ofl1VCN 10 PUUPESSLF ONII ......................- . <br />;.PCGI4l D[UVfPV (�dm fN ��W'��� <br />PS Fo.m NO INS�pAHCE COVFA�GI "PO���IPFO— f: <br />3800 NOi IOq IKT:6hhlr::l;l !�n�: ...�-, <br />1Pr. 7'�71 <br />. <br />in Ihe "RI'TURN TO"+p�ce on <br />= I Thc fnllow�inH seniir is rcqucsttd (ehak onc). <br />�> �w In u�hnm and darc drlicrrtd. ........_C <br />�$hou� m whom, d��e, and �ddms uf dclivery. ._< <br />(� RIiSTRICTI:D DLLNEAY <br />Show �n vham and d�re deli��ered. .. .. .. ._< <br />� RIiSTRICT'ED UIiLIVERY. <br />Show- ro vhom, date, and addrtss nf drlivery. S� <br />(CONSI'LT POSTMASTCR FOR fG[5) <br />2. 11NtIClE I1DD11E54ED TO: �� <br />Mr. Sam Mataen <br />9412 N.E. 60th St. <br />Seattle, WA. 98115 <br />3. ARTICLE DESGRIGTION: <br />AEGISTERED NO CEI11lfIE0 NO. INSURED ND. <br />I081873 I <br />1 have rtteiv<d Ihr arlVrly drxrib.� <br />S�GN�tURE n 9Mmsa•e .[� Wb�nrcd aCrnl <br />/� �u< 17 � , ..,., <br />5 �pDRE55 (CempUh only if r�yv/rfM) 1; I � I <br />� <br />( �.) <br />6 <br />lEC�USE \ <br />�4 n.o. m� nx va <br />