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Z 016 974 089 <br /> fONLip 2 11995 <br /> pec! ai <br /> No Insurance Coverage Provided <br /> Do not use for International Mail <br /> (See Reverse) <br /> Sent to <br /> Y CI,ARKE _--- <br /> ES ieY�EndOF FREDERIC CLARK <br /> 35 P ,. ,nd <br /> NA A CA 94558 _ <br /> Poslage $ .32 <br /> Certified Fee 1.10 <br /> Special Delivery fee <br /> Restricted Delivery Fee <br /> (1) Retum Receipt Showing 1 1� <br /> to Whorn&Date Delivered <br /> r <br /> L Return Receipt Showing to Whom, <br /> Date,and Addressee's Address <br /> TOTAL.Postage 5.52 <br /> &Fees G <br /> 0 <br /> O Postmark or Date <br /> Go <br /> E <br /> O <br /> LL <br /> rn wish to receive the <br /> CL <br /> me <br /> following services (for an extra- <br /> ?E <br /> xtra-SE m an6lor 2 f$r adttitional � .. <br /> rn Shack <br /> we can d <br /> o mpl to items 3,and 4a&b. d�r see's Address rn <br /> rs + Print your name and address on the reve a of!on <br /> a <br /> the back if spacqt return this card to you, 2 ❑ Restricted Delivery .5 <br /> > • Attach this form to the front of the mailpi <br /> does not permit. GP <br /> a Consult postmaster for fee. <br /> „ Write"Return Receipt Requested"on the mailpiece below the article num <br /> o The Return Receipt will show to whom the article was delivered and the date el s <br /> delivered. 4a. Article NU z <br /> a 03. Article Addressed to: <br /> ., R y,r <br /> CC <br /> 4b. Service Type ❑ Insured Q, <br /> MARY CLARKE KE ❑ Registered = <br /> FREDERIC CZAR Certified ❑ COD <br /> $ ESTATE OF Return Receipt for <br /> 352 DEER HOLLOW Express Mail ❑ Merchandisein <br /> c <br /> w NAPA CA 94558 7. t o°pffp ._Y o <br /> Cr :k 0 <br /> 0 <br /> A dress (Only if requested-t <br /> Q 8. Addresse ' <br /> and fee i <br /> Z 5. ign ure d r se F, <br /> F <br /> 6. Signature (Agent) <br /> u� <br /> PS Form 3$11, December 1991 �u.s.GPO!2993-- 2-729 pp STI RETURN RECEIP <br />