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i <br /> Q) <br /> � I <br /> ru <br /> Cr cv ' <br /> ir <br /> moo _ <br /> V E N O <br /> a) ti 3 aEi o d <br /> U0 <br /> �� d o a m LL m u=i d < m I <br /> N (n Q. O 55 ID <br /> > d n yY��1' m a <br /> «C.� `5 to W ai a) <br /> uj a) � _u a 0 ¢ d a o <br /> c _ o E E ee <br /> O O o " o E E <br /> (� <br /> :DCC z a/ c/�i in Ca a c i v�`i ¢ o a <br /> 9661 iudv'008E Wool Sd <br /> CAI <br /> SENDER: <br /> ■Complete iters 1 and/or 2 for additional services I also Wish to receive the <br /> 0 ■Complete items 3,4a,and 4b. following services(for an <br /> ■Print your name and address on the reverse of this form so that we can rQtur� is extra fee): <br /> card to you. <br /> > ■Attach this form to the front of the mailpiece,or on the back if space does not <br /> permit. 1. 11 Addressee's Address <br /> d <br /> y ■Write'Return Receipt Requested'on the mailpiece below the article number. 2. ❑ Restricted Delivery■The Return Receipt will show to whom the article was delivered and the date <br /> e delivered. Consult postmaster for fee. S <br /> 3.Article Addressed to: 4a.Article NumberCD <br /> �j <br /> a JAMES L EISK 70&Q "l� c <br /> o PO BOX 147 4b.Service Type <br /> �n FRENCH CAMP CA 95231 <br /> El Registered p'Certifiedfr <br /> w <br /> E3 Express Mail E] Insured c <br /> � N <br /> p ❑ Return Receipt for Merchandise ❑ COD <br /> a 7.Dae of Delivery <br /> z <br /> 0 <br /> 5. Re c ived By: (Print Name) 6.A dress;` 's Address(Only if requested <br /> w , - fee fts paid) <br /> c <br /> tY L <br /> N 6.Signature: (Addressee br X ent) <br /> 0 X <br /> T <br /> PS Form 1911, December 1994 102595-97-8-0179 Domestic Return Receipt <br />