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4 <br /> P 684 `5 8-3 459 <br /> Certified Mail Receipt <br /> { . No Insurance Coverage Provided r ,. <br /> Domnot use for- -international.Mall f <br /> UNITEDSTATES (See Reverse) <br /> POSTALSTUE <br /> Sent to <br /> Street&No <br /> a hxf <br /> P.O. State&ZIP Code - <br /> CA 15331, <br /> Postage = <br /> `- Certified Fee .. - '.. <br /> - " Special Delivery Fee, <br /> - x. r <br /> Restricted Delivery Fee -, a <br /> Return Receipt Showing <br /> rn to Whom'&Date Delivered o> f (f ; <br /> .Return Receipt Showing to Whom, - <br /> -ID Date,&.Address of Delivery <br /> IF <br /> ..TOTAL Postage ' <br /> . _ C &Fees - <br /> C Postmark or Date-; <br /> y M :a _ <br /> -.11 - - <br /> t, <br /> a_ 1 <br />