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<br />U.S. Postal Service <br />CERTIFIED MAil RECEIPT <br />(Domestic Mail Only; No Insurance Coverage Provided) <br /> <br />4 <br /> <br />Return Receipt Fee <br />1:0 (Endorsement Required) <br />Cl <br />Cl <br />Cl <br /> <br />Restricted DellvefY Fee <br />(Endorsement Requiredl <br />Total Postage & Fees <br /> <br /> <br />Postage <br /> <br />"" <br />ru <br />..; <br />Ir <br />t'- <br />Ir <br />..; <br />U1 <br /> <br />Certmed Fee <br /> <br />Cl <br />ru <br />ru Name (Please PrlntCfearly) (To be completed by mailer) <br />m <br /> <br />IJ"'" s'i;eet;Ajjt--:No:;-;ir-iioEjox7i(i.~-"---"~-.~--'---~._-_._-~~--_.-----~--_.----- <br />Ir <br />I:J ciiY.-siate;-Zip~~----_..'._~"_.._'--~-----_.'._----_._-_..- <br />t'- <br /> <br />PS Form 3800, July 1999 . See Re\ierse tor InstructIons <br /> <br /> <br />TJ <br />'G; SENDER: I <br />" . -Complete items 1 and/or 2 for additional seMCes_ I also wish to receive 'the \ <br />'ii _ Complete items 3, 4a, and 4b. following services (for an ( <br />= .Prim your name and address on the reverse of this form SO that we can return this extra fee): ". r <br />... can:I to you. . .o~ --- 0 I' <br />~ -:~.this:~.'JE,_~I,~ the front of the mailpiece, or on the back if space does not 1. 0 - Addressee's Address ~ 1 <br />G) -Write'Rstui7(ljijiCeipt Requested' on the mailpiece below the article number. 2. 0 Restr\cted DeliV8IY ~}' <br />oS _The Return ~ipt will show to whom the article was delJvered and the date ... I <br />a delivered ~W ' ConSl,lIt postmaster for fee. .~ 'r <br />il . 3. Article Addrrrd to: C _ Ad 4a. Article Number . / II i <br />li cd ~ 77(~ 'lJ9f J'a'O ..37J. 9#7' i ! <br />i fi-;;~~v.L6 ~ ~'~::;:r::e >>rtified [I <br /> <br />. 0 0 Express Mail 0 Insured <br />&zf:tt/":d / ~AI ~7J51ff elumAeceiptforMerchandlse 0 COD -_! <br />7. Date ot Delivery <br />" <br />o <br />::-1 <br />iii <br />FI <br />I <br />I <br /><,0.' J <br />/':Ptlmestic Retum Receipt I <br />.14/ _,,';~:_JjJ;;S1;;'~-oo_ ..__._ o,,_~_~_.~ <br /> <br />8. Addressee's Address (Only if requested <br />and tee is paid) <br /> <br />^ <br />