Loading...
HomeMy WebLinkAboutZ-02792 Applicationrn 0 0 v o (D YUC' � W o rt r a rt rt Pi H. Fl. p' rt m H. rn w O m �3'.n ch M i -h w G w G r° w rt H. H. G rJ�m(D b rJ ( M r rot CL $ co w Q o H. u' r• rt 0. ((DD 00 rt art o (tea a w M O rt ~' rt m rt ], rt k 'd t✓ '0 w w 00 G rt rt 0 m rn o' 0"Ft,r� rip m r• O r• O Ea m rD Z P 03 P. (DD rt w pi n m O (D w '0 F✓ rt Ili P) � rnw w ��.D " m u,rrt rt G rt w m G'• z 'F7 H. rt w m 0 0 G w O U' hH mo am (D n W w 03 K (D" (D rt go 10 H rt rt ((D rA Fl - CD H. v w o oQ F✓0 n H H. O Q w 0 O H M rn H. 0, m v ti 0, cn C/)Di 0 m r° r' m r° Fi .n G o 0 a. 6' ((D H-QQ O' Im_h Q' ((D o ro O H 1.4 at m rt O'Fmd HLo rt �3- `q rn Oo pQ G' m O m Or 0 Ft 10 (D H G rn H. r w rt H. rt G G CL p, 10 F-• �, � w m W (D m O w rr r= 0 O; O 0 rt r° r' f: F1 -s �4 'F• G F� � fn F✓ m rL W m w O rt - w o m '0 Or m H Fi 0 GQ G � m rt �r F+, m r• r� r -h w r• G r oQ r• GQ m w CL w .ca f� G 0 H. b m rt A. ul n � m O ?-10 F•h a r• rt ]' w H. G c n m 'o z '0 O Fl. rt to F'- t -n O 0 r° o' r� rt C w m h� o w° G Gr r• QQ rt O rt Ft, rJ' F -h (D H. 0 C) m r° rt n 0 F- F—' m 0 rt Fi '0 (D m pi Pi m rt �C w n m rt m n m w m G O a m m P, Pi m w rt r• n rt r° O b m n rt w r• r• QQ ril 0 m r• rot m G Da m G hJ 0 Ft1 r' tl m w r• M m a m O F+, ro Fi 0 -0 m Fi rt c ro Fi m m G rt En m o i� ro �s O m pi rrT ,rt l � rt (D cr r G �a n t (D 'O 0 m ol w rt G'• t7 w rt ri' t31 r° w rt f,19 rt O m H H. rt m rt 0 rt r• CD b n 0 10 M Fi rt 1-11 r• C m W rt m w r rt > 5 0+'0 m v, n 'G a -4 G r a,> GQ w 0 rr rt rt Fl - "0 va G` 0 m m rt o H. rh rt en r•yp� O n p m oQ rn GQ 0, w �C o o n � w w r• a� rt m r 0 � 0 rl � H. rt b m G r• G UQ o pi r 0 en H. 0 G rt Ft, NW 00 r � 0 rt m m Ft, r 9 o � > x Fm ltd 0 t__l 0 :� H. 0 w H. rt w ti G rt w a oQ F✓ en Q+ (D 1-s 0 W o t) � � o � r° G m CY N 0 m 0 n rt a0 r•o Fl- rt Ps w0=.4vn N GQ b O P3 O t. Ft, H- G r° G tom' rt QQ F a m O rt 0 l_n OD N a, Fi 0 fl9 Ffi U3 D� 1-d ro � d tl E o o ro It Cl b L � w r rt > 5 0+'0 m v, n 'G a -4 G r a,> GQ w 0 rr rt rt Fl - "0 va G` 0 m m rt o H. rh rt en r•yp� O n p m oQ rn GQ 0, w �C o o n � w w r• a� rt m r 0 � 0 rl � H. rt b m G r• G UQ o pi r 0 en H. 0 G rt Ft, NW 00 r � 0 rt m m Ft, r 9 o � > x Fm ltd 0 t__l 0 :� H. 0 w H. rt w ti G rt w a oQ F✓ en Q+ (D 1-s 0 W o t) � � o � r° G m CY N 0 m 0 n rt a0 r•o Fl- rt Ps w0=.4vn N GQ b O P3 O t. Ft, H- G r° G tom' rt QQ F a m O rt 0 l_n OD N a, Fi 0 fl9 Ffi U3 D� 9 ro ro H H H O Ft Pd N C H z G7 1-d ro � d tl U o ro It Cl b z�d ® � d C ro t7 F- 7 0 fin^ CEJ ° t7 l I ^� *�J i 9 ro ro H H H O Ft Pd N C H z G7 H en H ci C/) en t� H �.0 OD In T-1 LA) I ro H �d Fd n 0 n .o o ro � Fd t-I !4Cn t- to Fd • � n m o H '0 H o r-" o pa • a H � a m o rt p9 x'' r to 0a 0� o—*t� n w 'd o •d o ,-d m 'd P (7 C] o o rt rt ra m p m 010 o rt 6 I-a m�4 H `C i- H m m P' F- o 0 rt rt H. H) P, it 0 0 FA 'd o. N en s a+ 0 0 m Fd 5 m Pam • W m m pa H 0 hh 0 m H cu 6D C,' :a" pa cr w H PV H. m r-a n en ° op-} r• M t" 0 ria -% Fh P3 rt rh en en �d ere ¢e rt 7: a, m Qe LTJ 0 rt m. rta H H. Ue m rt p9 Pi m m 'd O m w rt rt FJ- �3' 63. m� Fh 0 m� m m ft r• m H� H Fh m r• Z o p 10 'd Yn ® H rt • Z Fh 0- b m :d b O 63. O O 0o wrom b !u� r•0 o H"0 �m en F-�H+�� P3 F r • rt o ® n m ps 04 rt pa n o (n r• w H. v P. o e' o 'd H• m ".� rta N o Fh m FJ • H • d o. m o 8',a o-d v. a 'o H. w pr rt m 03 00 H 'L9 pa m C] 'd N rt m w 00 --- N pa m 'd rt >d m. H. p9 F- w o rt p9 . " H. o p, ° `C rt a U ri ftrt r o a ro r• o � • 0 H en H ci C/) en t� H H. o Wow (D 0H10 rter b 0 Ili H 0 (D O' O I -h l7 rt fb C• H rn $ O G H• Pa Pd 0 I-3 Z H - �rt14 w0 vOG) n V m N 0 an O �' O 'C O (D La 0 H• H. Q rtPI 5C o (D (n rt H b O lb nt r o nrL� H 9Z (s rt 0 cc a H O C7 0 o rt m Qa rn N r H (D rt F r ren rn r{vn (D > C H, hOJ rt N H. rt' H m b rn 1-3 G H N rt z rt rh �c W H. � 0 N rt (nH• rn D] (D rn o PO rt m m H Fh rt a (D (DD (D En 5C z Fd rtrrP) aw 1-3 w H. H. n 09 rL GQ co 10 C1 n (D hh (D Pi H P3 rt W N P) C x w m rt oD cn r n o 0 rt m roh 04 P) rn rn H rt rt m rt x I O rt H. H. H in 0�. ((D (D (MD h Fd (D o b 0 Ili H p rt a rot ® N 10 "Uo V m N 0 an o m w La 0 H• H. n 7 o (D (D rt b O lb O P. (s rt 0 ° C7 H. rt C r r r O rt F r ren rn rt x fD P3 m .. G •• rn W H. � 0 N rt (nH• rn D] (D rn o H. Fh z o w H. H. n C1 n n n P3 rt rt x o 0 1-3 ;j • • til h C] a p a rot ® N CL H. 0 w r (D -+ an o m ri 4& r• o ca rt It o m o � r r r O rt co rt x (D G H. � 0 N rt rn D] (D rn o rt rt o w H. C1 n n rt rt x h � 01% 0 ao i V LA) rn U r FC m m HG• o n H n rt t74 EO rt rt r• w r -t � d w r• ri � v v v � W OQ r• tsm OR n m x phi rt ro W r v H z r• O � m r cn H >o 7d O ty r• z o ua n w rt 0 ii mm H. n rt rt � r• o 09 rt r• r• a� rt N o m rt 04 H. H. rt r w h+ El m rt (IQ 1 r,• \m ca o+ rt �rt Jm in. ct0 0 rt x m w 0 ro • a .. .. .. rn m a v v v t7 m m n m a rt 0 rt 14 O n m m w rt m n 0 m 0 a m a �t m N 0 op rt 0 ynro m m HG• o m 0 0 W w .. .. .. rt rt r• w r -t � d w r• ri � v v v � W OQ r• tsm OR n m rt 0 o 0 C r• 0 ° � m r � >o 7d 7v ty r• p 09 0 r• � a rt m m rwnr a OA o o a a g o b b m m nrt n C C rmn r 03 m rt .. 0 n w w n rt F, m ft a r rt bw PH ~ a a rt .. a rt a o pa m � � r• n w r r• m w Fh o n w rwt, H. rt CA 6Q m ynro � 1561 VV L a � 0 tsm LEVVIS I ,ST I =_,tip Clf) �T II-�J 6T L D tea? s m 3 m to t"i ,,j A a 0 o C+ •a 0. V Di1 /- I M C',m ° C O ,I yr O o H co ;f (D Cn n P. cF GA �I CD Cd H' O ro c+ IJ c.) O H �� va C) S1a h] u � H e—I N O N • U) O N C�• I y.. C* O t V LEWIS STREET c� m /z / ,"117 m In �mGl ro l'J 0 C? tTl avim > r w Q) - W tAri Q i tea? s m A 0 V Di1 /- M (.Ili U ° C p X yr O o H co ;f (D Cn n P. cF GA �I CD Cd H' O ro c+ IJ c.) O H �� va C) S1a h] u � H e—I N O N • U) O N C�• I y.. C* O t V LEWIS STREET c� m /z / ,"117 m In �mGl ro l'J 0 C? tTl avim > r w Q) - W tAri Q '4 LEWIS STREET Ql) 1") � ]� _ _ _ _ � � rn C) E47 I G) (f) /m 0 E: r) fTi 0 C) 'Aj z7D aG > Cn ��\ Do M > 0 Z ;o z p � (J) Z ;c rn 0 < p U)0 �| '4 LEWIS STREET Ql) 1") � ]� _ _ _ _ � � rn C) E47 I G) (f) /m 0 E: r) fTi 0 C) 'Aj z7D aG > Cn ��\ Do CA -i- cf) ,4131GIOIL 07- L-FW15 2EZ Al m 6T ............. w. 6T ;o C. m ru 0 0 H oil F-I rt w- H 0 rt rr ft CT o rt 2XI (D 0 CD CS) r, If0 r u, M, o W I (D 0 z �I I o P3 0. ITj P) M rr Ft. HO nyVj 0 oil �i LO F-4 rt Ft (D P-h 0F10 rt > (D 0 CD r., - Q, C1 F9 (Dro 01 r �-h H. T ' rt rt 03 t:" P-A Fl- 0 psi 0 0) m 5 I-h r- rt F- U P-ID N(D FJ F3 rt En (D 0 (D rt ri, 01 w (D James Brown 4123 West 17th Street Little Rock, Arkansas 722.04, Return Aece;pt Ru('.!?:aS .od Shavdng Add, : ii vv'lM Dn!UIMY'�d a JAN74� 73 Beasle �/tle t 16th Street Rock, Arkansas 72204 a I m 'ti pq w es` R `� `6 ro + wa fi x O ry r d Ni t i-- M ( r -d iw'F M rU f"f 'r 0 L-rj �" E n � r_+, 2: �5 I ".11 rt } Fri ro ® C -i W r • I �� ,: q� pim` ��' ter] Ai �m rt ~ CA N� w :-d Cn W N � ��qjj 7� h � N �'' (D � : � �h t o f Ft, (a ry 43 rt � 1 H''� �" T' � Ga 10 � � �-ol U i rt. Ol �Fd 4 � N,' r� Q LQ m V.. N m d HF+�p 'TJX H I O b gW tb i N• m a ►�� rt ul fl,PI o Fa r rt n a •.� Ra n a' � � ,l ' U F'• v w ,. VOZZL sPsuaxIV 'NOQU 0T-4-4 I '4aaa'4S ug9T aM 9TZV suTxaaa -W , basw • syr 9t3t7..ub a 0 ,zzNnr � �d w�(J Gid "P" +. r S _ p JOA11aa BA94M sseApp,4 BUIM04S pa}senb®d IdIlOSH uInj®a tOZZL S..PsuaxaV 'xaog 9144T'I 4aaagS ugLT 4s9M Ult UMOJE[ sauisr �{r ij � �c.�. t� �a ►moi � c~�' � �. ►tet 7� Ul g 0 C l '0 1Ht yrJ o O t* �' r+ cr d J 0� rt (t a M ' )-h 0 ` ' `C H I wr, m _n C4fj M ?C m r n m w EQ t-4 r ati rr C w J ra r� 0 R► J y re] t-3 fa r. r cam. ro '� f 9 0 V lul b r1 t-4 U) w 0 ru r 3 Al () . rn Lb r4 H rt H. tj M O C h- F N n C'1 f j I- PI H. Ct l n O I~+i ra n M rt rt 'ill -1 tx7 � N m is l 0 0 " 07 m s t 1^i n LaJ "d rn l: c5 1'`' G V N• 0 Ca 0 CfQ I h-'• 'rte . �-+•� I...lb rT r -r co LQ lro ll N. h C Vl O" p� m �. w N G t 9 P4 0 moi. C7 ro m rt w IV m 1-3 rtp. to 0 0 N H N• M Is N, U. rt CL rt cr trin i �" 0 CA H 'm F1° z r �{r 0 0 (D 0` Fi w I a- ?T Fj ?C H t-4 kid F-4 r > e 1 b C'1 f j I- -1 tx7 rxJ W, W 0 0 (D 0` Fi w I a- James Brown 4123 West 17th Street Little Rock, Arkansas. 7220.4, To ReWW Receipt Requested Showing Address Where Delivered U. JAN 22'74 >� 5a', s 73 hrti I [.!1.34 toy L-- Mr. A. A Ardnengo, Sr. 4215 We t 16th Street Littl Rock, Arkansas 72204 I �]3• a -I 0 n ft ��l M rpt r� ra rt 0° rt Ao r` t a H '?,« ►"a I --I ry � it �.j C4 Lb M a m ;b �g 4 w LT ro �� ! pC tp fn n r•-] N H w (D „ F t� ID o C) o ti, Fj in moo" a'�„ m' rD F4 i � r. bd txj ri. C)" rt O Com N �NIJri itl ;4N rt NP) P4 a, rt $2 w. .r H 1t r ry N1iA rt It L i 1 ily c• p i d to K moi: I 4 I�•yr' ` ly`1 rl' •I /(D. :�I rr, 4Vi{� rt eGQ U] L rt 0 S` :J rA I J 45 V 04 y1RJ b bWi rt � ra CF vl t'> rt O Fl- (p cl Ln H r a C') C, r, p" r.i CI] Cl+ LO Im 4cn James Brown 4123 West 17th Street Little Rock, Arkansas 72204 Return Receipt Requested Showing Address Where Delivered :�, �,..��� R1.S.�►USTflG� I.J.73 34 r- 65 L...,.,... ,.,...�. n Mr. m Mitchell 421.8 WXst 16th Street Little hpck, Arkansas 72204 Wow e H L lu rt 0 Q ft th -j QQ rt 0 0 1 Od c EA 41 lial, r{ N r QQ rr <i En (D rt O LT.1ID cn 0 t -fl 5 C, �4lDj N F- co td I IMm Cad0 o lb "J H.- H. m 0 0 1-9 1-4 F-4 N cm 0 CA 'o (D F -JI u ft t -h 0 F- :� K)oq F-3 t -h 0 tt t-4 F3 (D Pi c - rt 4"Y F -I Cl ITJ r4 a, (D C/) ci OQ rj) ul H J.'. P. rt rt 0 F-) 0) rD 0 'o 13 m rt H. rt Ga cn fi r t -t 24� rt 0 F -J ct C7. En 0 al C) cn v H m rt James Brown 4123 West 17th Street Little Rock, Arkansas 72,2-04 Returr, Receipt Requested SjwwIng AcIdyn,".S Where DO"t"" t -F IA'ja• J AN 2 2'7 4 71 )I? A M Z 73 1 ,4 1 0 $v 1- Mr. H. G. Yancey O 4217 Wes 17th Street Little R G. Arkansas 72204 Al i W I 'T1 i o .• rF :J ri C� F -d tQ y sn 0 r, M n rt O O rt v rq x" Q rt rt C H H, O rt rn r'•' P> � 7' Cif Qf ((D f9 r • �� n � � m rr Z -j F �r Ffl iZ. 'J fD O, "t9 o Vi CS tp N F .I r+ rp O Joi (D r N C'7 n t' 1-3 rP. O (D pf in A. rt rt, �, r., ,r. O ! o �� t.0 W W P �' tQ ,v F;, r rt W O h: A ° w r+ � C� L1 r rt 'f + (D (D + i� ton rnrt, N� rt U] h1J fD 1f 1 h1 rf (D rt CJ Qrf] r• �r F,• , . ;4 ro 01 t7" � � • r7 M A IXA L7 C1 o 10 ri Cl. rp 44 rt H ri (D Qrt W' M1 m rt 0 t4 m W r a° �cy i7, (D r• rn K p. ko W I 'T1 i James Brown 4123 West 17th Street Little Rock, Arkansas 7220-4 Return Receipt RegUoWd ".:=,jvn►i,tg AddrM where Delivered J JAN22'74 73 LI ROck Mr. Them Murray �ittle Own r 4201 We 17th Street Little Rock, Arkansas 72204 //I �eseaw ; cvr! p r3 Lry T tD (A ("t �-4 Curt Cm M L 9 (n Q I Tj 0 0 UD tv 0 rt p 0 0 rt CA n 00 rt ct X, 0 r" V-1 I'd &I rT 7. C4 P6) M rt =r ru (D F-4 M C) 0 I -D 0) (D cn tz rt a) on P3 0 o W H- En 0 (D L-; rp ru P-3 F-3 Llij m0 1-b 0. rt Fl 0 F -I vi s. > 0 H rT rlt Lo 0 0 > r�r F -q ty 0'0 F-4 m 01) rt, fa m 10 '7 rt o �r, M LlN• ldJ o I c7 C) m co ol (D gn. rt 0 W (D 0 0 10 p rr w- tj Pul M rt R fn � ril r) rt 0 Fj m 0 ti' 13 A f�m1 ;J' rt CL rf F -J Ar I.p al w 4 0 co H. ro James Brown 4123 West 17th .Street Little Rock, Arkansas 72204 hj�ldraj Ji&Wp Requemd Mr. Charles Jordon 4301 West th Street Little Ro Arkansas 72204 .t. U.S. POSTAL SERVICE y n OFFICIAL BUSINESS''' a - �_ a ( T ALTY FOR P12F;C -rr- I" TO AVOID P OF POSTACr Postmark of Delivering Office a SENDER INSTRUCTIONS co a Print in the spate betow your name, address, including ZIP Code. RETURN a�' • If spnclal snrvlcea me desired, check block(s) on other side. �® r—I ® • Mointon gurnnul ends and attach to back of articlo. 4W 00 James Brown M € 4123 West 17th Street LL Little Rock, Ark. 72204 a C es m MM SENDER: Be sure to follow instructions on other side PLEASE FURNISH SERVICE(S) INDICATED BY CHECKED BLOCK(S) (Additional chargee rrauired for these services) rtrShow to whom, date and address Deliver ONLY where delivered ❑ to addressee Iitc Il'T Received the numbered article described below REGISTERED NO. SIGNATURE OR NAME OF ADDRESSEE (Aruo4 ahcays be filled in) CEWIED KO. 2 SIGNATURE OF ADDRESSEE'S AGENT. IF ANY INSURED NO. DATE DELIVERED 1 sl/.— i M r 4 GO D cn ® q C o Z zap m op 0 7O CLa uy a1 CL O e CL 9 ® m o CL 0' N. to r P� o � (mj Q. AaM n W o.OZ a k ^i nn (q I I. M P.0. '0 u 90. nrn ` w ez 02 n CA M ® M0 d 00 m `; Fl o —a 0 N n. gym. n' O O a - p 0' o1 Pri g m < CB SENDER: Be sure to follow instructions on other side PLEASE FURNISH SERVICE(S) INDICATED BY CHECKED BLOCK(S) (Additional chargee rrauired for these services) rtrShow to whom, date and address Deliver ONLY where delivered ❑ to addressee Iitc Il'T Received the numbered article described below REGISTERED NO. SIGNATURE OR NAME OF ADDRESSEE (Aruo4 ahcays be filled in) CEWIED KO. 2 SIGNATURE OF ADDRESSEE'S AGENT. IF ANY INSURED NO. DATE DELIVERED 1 sl/.— i 3 Nt ILI"ERED [ of reCueaae orad ins Z] Ledo) jf/ I Y M r m D cn IM m CD 7O ro �7 a1 CL O fD 9 - -C CL 0' N. to r P� triq W o.OZ Y v� '0 u � A ez -� r�3 n n y Fl 0 d 5 C n' O a - p 0' o1 Pri g m < CB 1 R w 69. rn O 0 En 0 CD v 3 Nt ILI"ERED [ of reCueaae orad ins Z] Ledo) jf/ I Y qq U.S. POSTAL SERVICE w OFFICIAL BUSINESS N Jar\ do . 1 ALTY FOR PtiTV" lr- �� U� TOAVOIE)P 7� OF POSTAL' a Postmark of Delivering Office r, m SENDER INSTRUCTIONS 4 � Print in the space below your name, address, including ZIP Code. • If special services are desired, check block(s) on other side. PI a Moisten gummed ends and attach to back of article. 7-4 --- MJames Brown e 4123 West 17th Street Little Rock, Ark. 72204 a s�. r ?A M �J oCAe r Q z ern P y C v m° z w 00 a v C4 N + C to 0 n = ea ® 3 m m o \ M &m a t - J M r� � -� e m g rn 0C1 O rn C7 •� m W 0 KSI a '� h y M O h m C-) o M 0 Q C �t r mZ O V ® !< 7c RETURN .TO SENDER: Be sure to follow instructions on other side PLEASE FURNISH SERVICE(S) INDICATED BY CHECKED BLOCK(S) (Additional charges required for these services) Show address Deliver ONLY where delivered to addressee RECEIPT Received the numbered article described below REGI5TE SIGl�l1RE Ott FIAT OF ADDRESSEE (Must always be frfPeo! in) C@RTlFIE ` NO. C j�' C� `tY S GPIIITIItL INsuPiED Nil. .2 -- �- DATE DELIVERED SMp14 WHERE DELIVERED (OWU if vequevted, and incdudo ZIP Code) I ee —�•0 N d A n m a• ii 11 ro r M e . u) =r= CDD O e 0.0) m a a� n rD V7 r rn o C I -q N Z . v �rn a. v 'a m �'1 0 0p O N r,y m= v Q@ r O O N 0 (D v N y� M rYr co O rn rn m ei m a m M z a M i III ID N o, N D w q � +t rn 70 Lai � i'IY nj w `E7 a -t iD. O� M rr rn rst rD C1 s a o O r. k Q H 0- cn O r r m � e. U.S. POSTAL SERVICE OFFICIAL BUSINESS PENALT& USE ;18OID IMA+dMCAFI' QSPAQE 3300 1'aafmvrk of Delivering Office CD SENDER INS'TRl1CTIONS RETURN o Print in the space below Your name, address, including ZIP Coda. TO • If special services are dashed, check block(s) on other side. z • Moisten gummed ends and attach to back of article. � James Brown 00 4123 West 17th Street C0 E Little Rock, Ark. 7A204 >C SENDER: So sure to follow instructions on other side PLEASE FURNISH SERVICE(S) INDICATED BY CHECKED BLOCK(S) (Addi.tio?tal charges reg2dred for these services) PrShow address Deliver ONLY where delivered to addressee RECEIPT Received fire numbered article described below RE GISTE E: Si6NATl1R SIR N#M (iF ADDRESSEE (Must always be flfied in) CERT�•IE �NQ. C. C( 4:, S Gh1ATU&c C1F .4D R1 -SSE GENT, IF ANY INSURED NO. _ I DATE DELIVERED SHOW WHERE DELIVERED /(Gstly if re jac4led, ansa molude ZIP Code) A w re Q s� t Q CL 0 MrnI C j �9 47j � M tr rn r rn Q- M a- 3 C m tr CLC " � 1 j n " V P97 Z qy - rn f L7 s m o -M m '� m ;D rt cw .o N a c. � PTf M 0 m n r'It v ii 4 � N f° m n a 10 q 0 A 4 w 4 d w C.. r in ®' R m 0 p t' n 003 w 9 0..M a , CL Q M n ;s %`D (A O Q p k I (D SENDER: So sure to follow instructions on other side PLEASE FURNISH SERVICE(S) INDICATED BY CHECKED BLOCK(S) (Addi.tio?tal charges reg2dred for these services) PrShow address Deliver ONLY where delivered to addressee RECEIPT Received fire numbered article described below RE GISTE E: Si6NATl1R SIR N#M (iF ADDRESSEE (Must always be flfied in) CERT�•IE �NQ. C. C( 4:, S Gh1ATU&c C1F .4D R1 -SSE GENT, IF ANY INSURED NO. _ I DATE DELIVERED SHOW WHERE DELIVERED /(Gstly if re jac4led, ansa molude ZIP Code) A w re Q s� t Q CL 0 MrnI C j �9 47j � M tr rn r rn Q- M a- 3 C m tr CLC "