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f f <br /> Z 18-7'_935 628 -` - <br /> US Postal Service <br /> Receipt for Certified.Maii' <br /> ! No Insurance Coverage Provided. - <br /> Li Do not use fo`r International Mail See reverse <br /> Sent to <br /> Street&Number - <br /> Post Office,State,&ZIP Code <br /> Postage r r <br /> Cerfified Fee <br /> Special Delivery Fee' <br /> Restricted Delivery Fee <br /> t LO <br /> 0 Return Receipt Showing to <br /> I Whom&Date Delivered [ X <br /> a Return Receipt Showing to Whom, E <br /> Q Date,&Addressee's Address <br /> 0 TOTAL Postage&Fees $ T <br /> Postmark or Date , r <br /> 0 <br /> d <br /> SENDER: -19( F 5 '1� L <br /> ':Complete items 1 and/ofor additional se ces. �' rn I also wish to receive the <br /> W ■Complete items 3,4a,and 4b. following services(for an <br /> d ■Print your name and address on the reverse of this form so that we can return this extra fee): <br /> card to you. ai <br /> > ■Attach this form to the front of the mailpiece,or on the back if space does not j <br /> 1. ❑ Addressee's Address <br /> d permit. <br /> d ■Write'Return Receipt Requested'on the mailpiece below the article number. Q. ❑ Restricted Delivery <br /> ■The Return Receipt will show to whom the article was delivered and the date I <br /> c _delivered. Consult postmaster for fee. <br /> } 4a.Article Number Q w t <br /> 0. JERRY MOORE ' '9-7 67 3 S— �O a' c <br /> E MOORE PETROLEUM4b.Service Type d <br /> rn P O BOX .57 { ❑ Registered � Certified cc ' <br /> BANTA CA 95340 <br /> .0 Express Mail ❑ Insured y i <br /> c G' `❑ Return Receipt for Merchandise ❑ COD <br /> a 7.Date of Delivery ° <br /> z o <br /> T <br /> % <br /> p 5.Received By:(Print Name) 8.Addressee's Address(Only if requested r, <br /> LU and fee is <br /> c 6.Signatu'e((Addresse or Agent) <br /> 0 X <br /> PS Form 3811, December 1994 Domestic Return Receipt <br /> I <br />