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SENDER: • <br /> W • Complete items 1 and/or 2 for additional services. -- - Ish to receive the <br /> • Complete items 3,and 4a&b. folloWing Services (for an extra m <br /> • Print your name and address on the reverse of this form so that we canv <br /> d return this card to you. fee): ` <br /> N • Attach this form to the front of the mailpiece,or on the back if space 1. El Addressee's Address fn <br /> does not permit. , <br /> _ • Write"Return Receipt Requested"on the mailpiece below the article number. 2. ❑ Restricted Delivery G <br /> *' The Return Receipt will show to whom the article was delivered and the date <br /> e delivered. Consult postmaster for fee. <br /> cc <br /> -03. Article Addressed to: 4a. Article Number <br /> °' X0169-739ys <br /> °' Fr <br /> At ,e. a mr4 <br /> C1 �l 4b. Service Type <br /> / // 9 / _ff ❑ Registered ❑ Insured <br /> ti C.� f/iE' °'Qj1` t>,S. A. (/hOWUG�'y L(j. 9 � <br /> NCertified ❑ COD 5 <br /> W 11 06L()p ❑ Express Mail ❑ Return Receipt for M <br /> p� Merchandise `o <br /> QO f � t7y r� 7. Date of Delivery r� q r «- <br /> JC4 M Ka rrt6�1� /l J�Q 3 �UU i i��J T <br /> CC5. Signature (Addressee) 8. Addressee's Address(Only if requested Y <br /> and fee is paid) <br /> LU <br /> H t <br /> 6. Signatur <br /> yPS Forr,�'381 , December 1991 *U.S.GPO:tg23—a5Z714 DOMESTIC RETURN RECEIPT <br />