Laserfiche WebLink
^r SENDER' ��? a so wish to receive the <br /> m following services(for an <br /> +� NGdfi"I�li3lD!!�llf 1 @Il of f9f 1►� Ilion. senrlaea. � <br /> ■Complete items 3,4a,end 4b. extra fee): <br /> � e dre96 the reverse of this farm so that we can return this Z <br /> �p sP�M your nameAddresseds <br /> J �itl 10 y011� ti, 'reg 10160A,or on tf1t bade if apace does not 2 ❑ Restd ed De very N <br /> ■Attach this form �� itis number• <br /> pe""'t. w Consult postmaster for tee. g <br /> *Wrile`Rehrm Recerpf Re4UBst:on the ma d the date <br /> m ■The Return Receipl � � <br /> m o <br /> da ivered. ti�YllFi a.Article Number E <br /> 3.Article Addressed to <br /> m <br /> 4b.5ervice ype Certified CM <br /> ❑ Registered p�nl Insured c <br /> BYFORf D ��¢/3 n LSC in <br /> VIRGINIA } ❑ Express Mail <br /> 809 18TH ST i 9827 4 ❑ Return Receipt for Mershandlse ❑ coo r <br /> N t l'iT VERNOI�3 7.Date of Delivery s. <br /> � - - <br /> O !Ynif requested <br /> resseeAddress c <br /> Add 's ( <br /> 5. d ReceiveBY <br /> Print Name) and tea is paid) <br /> S.Signatu : (Addressee or Agen <br /> o aii�lesttt�rn sept' <br /> y, X 102595-97-8-0179 -1 <br /> ps Form 3811,December 1994 <br />