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' ! I ! • • • DELIVEqy <br /> A �p �j'yed py(Please Prinl CIMIY) 5, Date of Delivery <br /> ■ Cp <br /> Dm late rf8n1S 1 t 1f 8nd$.NSO c O ILII _ <br /> item 4 if fiestricted OeGVery f3 es tore Agent <br /> ■ Print your name and raddress on the everSe [3 Addressee <br />+� so that we can i 171M mailpiece, X ' <br />,q I�erf1 [3 Yes <br /> ■ Attach this c ace permits. •'iT 'ti ' address different from <br /> X or an the front if sp <br /> D. is delivery address w; NO <br /> If YES,enter deli�er7+ <br /> 17, j. Article Addressed to: <br />.0 <br /> rru tES F TOWN MAIL `f U L 3 Service�Ype d Express Mail <br /> C3 la VEBER 3R1? STREET 14C 3'all <br /> o �I 20 SOUTH EMT-"" 'l7 Fte9l`*, �Return Receipt for Merchandise <br /> C3 y COLUI'IBUS OH 43215 PEK,W,l, p ingur`ad Mau ❑c-o-o. <br /> Fee) ❑Yes <br /> Ca q, Restricted Delivery� (Extra <br /> .0 r ps <br /> C3 ' <br /> C3c from 5ervice label} t{52595-�- t)952� <br /> 2, Artoe Nusttber(GopY <br /> C3Domestic Return <br /> C2 Receipt <br /> 'city, <br /> PS Form 381 1 - <br /> AO <br /> !! <br />