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SEWN: <br /> •Complete items 1 and/or additional services. I also v'' to receive the <br /> a •Complete items 3,4a,ai followlrvices(for an <br /> •Print your name and add4!Son the reverse of this form so that we can return this extra fee <br /> card to you. E <br /> -Attach this form to the front of the mailpiece,or on the back if space does not 1. ❑ Addressee's Address <br /> W permit. 41 <br /> y . <br /> Write'Return Receipt Requested'on the mailpieca below the adicle number. 2, ❑ Restricted Delivery y <br /> -The Retum Receipt will show to whom the article was delivered and the date «a <br /> delivered. Consult postmaster for fee. u <br /> 0 <br /> 3.Article Addressed to: 4a.Article Number <br /> 2 3-to ` tcog S9Z E <br /> E ATTN STEVE CLEMENTS, BRANCH 4b.Service Type y <br /> 0 S & E ❑ Registered aZCerhfied <br /> rn WESTERN FARM SVC, INC - STKN <br /> In ❑ Express Mail ❑ Insured <br /> P.O. BOX 5188 ❑ Retum Receipt for Merchandise ❑ COD <br /> o STOCKTON CA 95205 7.Date of Delivery <br /> a <br /> = 3 �5 0 <br /> 5.Received By: (Print Name) 8.Addressee's Address(Only it requested c <br /> w and tee is paid) a <br /> / F <br /> 6. g Stu e: (A res a or Agent) <br /> PS Fo3811, December 1994 102595-97-e-0179 Domestic Return Receipt <br />