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<br />SENDER: <br />· Complete items 1 and/or 2 for additional services, I also wish to receive the <br />· Complete items 3, and 4a 8< b, fol/owing services (for an extra co <br />· Print your neme and address on the reverse of this form so that we can fee): .M <br />return this card to you, ? <br />· Attach this form to the front of the mailpiece, or on the bsck if spsce 1. 0 Addressee's Address Jl <br />does not permit, "" <br />· Write "Return Receipt Requested" on the mailpiece below the article number, 2. 0 Restricted Delivery .i~ <br />· The Return Receipt will show to whom the article was delivered and the date ~ <br />delivered. Consult ostmaster for fee. ~ <br />4a'pArticle Number -- a: <br /> <br />D- 7/~-1'il S ~ <br />.... <br />4b, Service Type ~ <br />o Registered <br />~rtified <br />o Express Mail <br /> <br />/.......... <br /> <br />+- <br />"- <br />II <br />:g <br />fIJ <br />II <br />f <br />!: <br />l! <br />CD <br />.r:. <br />.. <br /> <br />c <br />o <br />i <br />.. <br />II <br />Q. <br />E <br />o <br />u <br />U) <br />U) <br />~ <br />a: <br />C <br />c <br />c( <br />~ 5. <br />::) <br />I- <br />~ 6. Signature (Agent) <br />... <br />::I <br />o <br />>- PS Form <br />.! <br /> <br />~fl~a-~1::t~ <br />) ~.2lUk..I\lUs~4--y A V~ <br />~+& ~ I) /Y)I\) S JO~- <br />J'1Ci' <br /> <br /> <br />11. December 1991 <br /> <br />1l'U.s. GPO: 1~.714 <br /> <br />,r-'. <br /> <br />-_"'_"._40' <br /> <br /> <br />7, <br /> <br /> <br />~ <br />t: <br />'iij <br />::l <br /> <br />., <br />CJ <br />.... <br /> <br />8, <br /> <br />DOMEST <br /> <br />URN RECEIPT <br />