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v� s <br /> - <br /> a <br /> i <br /> F i <br /> Certified Mail . eipt <br /> } = No Insurance CoverageiProvided <br /> Do not use for Internat'Oial Mail <br /> ! (See.Reverse).. <br /> Sent to <br /> Stn: &No. <br /> �- <br /> .0.-6 6 = <br /> P.O.,State&Zip Code• "y 2. - - <br /> I - - <br /> -Postage <br /> Certified fee '~" <br /> -Special Delivery fee <br /> • - Restricted Delivery Fee <br /> Return Receipt Showing <br /> 0) <br /> W to Whom&Date Delivered <br /> Return Receipt Showing to Whom,' - '.i� t i <br /> Date,&Address of Delivery - ,i i <br /> 3 t <br /> ") TOTAL Postage - �` - _ } <br /> r p &Fees _ $F+ ! <br /> co Postmark or Date=- - <br /> i <br /> r � <br />