35-169 (9) UNITED STATES POSTAL SERVICE
OFFICIAL BUSINESS
UNDER INSTRUCTIONS
�t Y�name,addrsss and 21P Code
'�Compiats keme i,R,S.and 4 on the
revew
uO
• Attach to front of artkde if apace "
=.I otherwise&M to beck of
PENALTY FOR PRIVATE
• Endons article "Return Receipt USE, 1300
R"W$W"adjacent to number.
RETURN Print Sander's name,address,and ZIP Code in the space below.
TO
• SENDER: Complete items 1 and 2 when additional services are desired, and complete items
3 and 4.
Put your address in the "RETURN TO" Space on the reverse side. Failure to do this will prevent this
card from being returned to ou.The return receipt fee will provide the name of the erson delivered
to and the date of delivery.Fora additional tees the following services are eve a e. onsu t postmaster
or fees anc,ChecK DOXtOSI for additional service(s)requested.
1. 0 Show to whom delivered, date, and addressee's address. 2. O Restricted Delivery
(Extra charge) (Extra charge)
r
3. Article Addressed to:v (�, 4. Article Number
(V/ Type of Service:
❑ Registered ❑ Insured
`j �,Certified ❑ COD
' '\�/`� ❑ Express Mail foe Receipt
C J (/ for Merchandise
Always obtain signature of addressee
or agent and DATE DELIVERED.
5. Sign a Address� 8. Addressee's Address (ONLY if
requested and fee paid)
X
ignature —Agent
7. Date o Delivery
2 2 ' V
"' -•-- QQ • u_S.G.P.0. 1988-212-865 DOMESTIC RETURN RECEIPT