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P 5`iU 44-4 eyO <br /> USP stat ir&i�Q'MAwl <br /> Receiptt �Q' <br /> HERMAN WEBER <br /> 230 N CHURCH ST <br /> LODI CA 95240 <br /> Postage $ <br /> Certified Fee <br /> Special Delivery Fee <br /> Restricted Delivery e <br /> LO <br /> rn Return ce t <br /> Whom D e red <br /> Q Retum R eipt ng to Whom, <br /> Q Date,i£ ess s Address <br /> cD TOTAL Postage 8 Fees $ <br /> W <br /> M Postmark or DLLa <br /> 30 <br /> SEN ' �`�" also wish to receive the <br /> a ■corn it�msr 2 for additional servyc�s folio e�jlc s for an <br /> ■Com to itoms 3,4a,and 4b. l/ eXtr � d �9�J <br /> d rlRrint your name and address on the reverse of at we can return this ai <br /> C card to you. <br /> ■Attach this form to the fronta Ipi e,o on t back if does not 1. ❑ Addressee's Address <br /> ` permit. be rliCllcffumUK 2. 13Restricted Delivery 0 <br /> ■WriteTatumReceiptReque . <br /> rGThe Return Receipt will show towhomthe article as e d and the date Consult postmaster for fee. ° <br /> delivered. <br /> ° 4 . rticle Number , d <br /> 3.Article Addressed to: _ <br /> i HERMAN WEBER 4b.Service Type <br /> f230 N CHURCH ST Certified a: <br /> c ❑ Registered <br /> c rn <br /> a LODI CA 95240Insured c <br /> ❑ Express Mail <br /> a <br /> ❑ Return Receipt for Merchandise ❑ COD 0 <br /> a $ <br /> 7.Date of Delivery '~ <br /> c 0 <br /> aPR <br /> — s Mesa <br /> Z T <br /> l <br /> 8.Addressee's Address y if requested <br /> 5.Received By: (Print Name) m <br /> W and fee is paid) t <br /> X <br /> F <br /> 0c 6.Signature:(Add�see or Agent) <br /> X _o <br /> PS 1= 3811, December 1994 !� Domestic Return Receipt <br />