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x <br /> I <br /> Z-a128 782 691 <br /> .US Postal service _ <br /> 'YRecejpt for Certified ati <br /> No insurance Coverage Provided. _ <br /> Do not use for International Mail ee reverse <br /> Sent to <br /> J Prs Bo <br /> Street& umber <br /> 0 A <br /> Post t?trice,Stets,&ZIP code <br /> Postage $ <br /> Certified Fee <br /> Special Delivery Fee <br /> tn Restricted Delivery Fee <br /> 4 � <br /> Return Receipt Showing to <br /> r Whom&Date Delivered <br /> f Q Retum Recent Slrerrri;g to Whom, <br /> a Data,&Addressee's Address <br /> 0 TOTAL Postage&Fees $ <br /> C7 Postmark or Date <br /> 0 <br /> 0 <br /> F ;I <br /> ,$ SENDER: I also wish to receive the <br /> r Complete items 1 andlor 2 for addltlonal services. following services for an <br /> R q ■Complete items 3,4a,and 4b. g <br /> ■print your name and address on the reverse of this form so that we ca i return this extra fee): rr <br /> card to ou. � <br /> * ■Attach this Conn to the front of the mallpleca,or on the bads H space, not 1.Q Addressee's Address <br /> grits <br /> k <br /> r Writs"Return Receipt Requested"on the mallplece below the article n imber. 2•❑ RestricteoDVilvery t f <br /> # a The <br /> delivered. <br /> Receipt will show to whom the article was delivered and date (,pnSU fee. f <br /> 3.Article Addressed to: 4a.Article r <br /> r <br /> b.ERNFST J POMBO JR Regisl'6dpe �g�i�Ce i led 9 r <br /> �,10 � � <br /> PO BOX $05 Express M8Q � is red <br /> �� O1 i <br /> ' TRACY CA 953`x8 11 Return Receipt for Me oP D . <br /> g � <br /> j . Dale of D� � ��� 4 <br /> may. 5. RteB : (Print e) 8 Addressee's Address(Only if requested ` <br /> a� <br /> p � and fee is paid) <br /> � r <br /> 6. Ig a re: (Addre e f en ,z <br /> X <br /> f <br /> "� PS 11,December 1,994 tozea gs-e-azze Domestic Retum Receipt <br />