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P 37[9 7615 {870 <br /> U oMat de b R Q 1 93 <br /> Receipt for Certified Mail <br /> BRETT LARSQN p -- <br /> UNION ICE <br /> 6100 SHEILA ST <br /> LOS ANGELES CA 90040_2407 <br /> Postage $ <br /> Certified Fee <br /> Special Delivery Fee <br /> ul Restricted Delivery Fee <br /> Return Receipt Showing to <br /> Whom&Date Delivered <br /> ii Retum Receipt Showing to Whom, <br /> Q Date,&Addressee's Address <br /> O <br /> TOTAL Postage&Fees $ <br /> C0 Postmark or Date <br /> o` <br /> rn <br /> a- <br /> ■C pl ndlor 2 for additional services. � jh to receive the <br /> m omplete items 3,4a,and 4b. following services.(for an <br /> 0 ■Print your name and address on the reverse o his o a w r u extra fes)? � �„ <br /> card to you. <br /> ■Attach This form to the front of the mailpiece or on he a pac 1. D Addressee's Address <br /> permit. <br /> t ■The Raturn <br /> Receipt Re ow a whom the anide wasdel delivered ed'onthernai i ow the land the date 2. ❑ Restricted Delivery <br /> delivered. Consult postmaster for fee. <br /> UO <br /> 0 Arsicle umber <br /> a 3.Article Addressed to: /V)✓_�:! <br /> a <br /> BRETT LARSON 4b.Service Type m <br /> UNION ICE <br /> C1 Registered Certified rn <br /> 100 SHEILA ST F ❑ Express Mail Insured <br /> , <br /> LOS ANGFLF S CA 90040-2407 ❑ Return Reoeipt for Merchandise ❑ COD <br /> 7.Date of Delive <br /> ff 7 a <br /> Y <br /> 5.Received By: (Pant Name) 8.Addre se s dress(only if requested = <br /> F., and fee is p d <br /> 6.Signature: (Addressee or Agent) <br /> X Domestic Return Receipt <br /> PS Form 3811,CWcember 1994 <br />