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Z-02486-A Application
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ZIP CODA i Aw POSTMARK OR DATE RETURN Shows to whom ehd date dellveratl Grp 7.. With restricted dollvery -- RECEIPT FOR CERTIFIED MAIL } p�" {' 1 RECEIPT 2, SENT TO S TO !/ ` POSTMARK OR DATE 4 OR DATE (extra fee required) • ••- • ••- NO INSURANCE COVERAGE PROVIDED-- STIffET_AN NO (See other side) Jan.1976 3800 NOT FOR INTERNATIONAL MAIL y1 GPO: 1975-0-591-452 and where delivere SERVICES P.O., STATE �AND ZIP COOODD/E(/ SPECIAL DELIVERY (extra fee roquired)... ............... ....•........... y l I OPTIONAL SERVICES FOR ADDITIONAL FEES (See other side) RETURN . Shows to w oln anti- date dellvared ......� With re5trlcted delivery RECEIPT RETURN RECEIPT 1, haws to whorn aad date vared .......... With restricted dellvery � 2, Shows to wham, date and where delivered 2, Shows to whom, date and where delivered V SERVICES With restricted delwary RESTRICTED DELIVERY Q SPECIAL pELIWERY (extro fee required) ...................... ... SPECIAL DELIVERY (extra fes required) •• • •••••• •• .•••••• + PS Form NO INSURANCE COVERAGE PROVIDED— Jan, 19763800 (See other side) NOT FOR INTERNATIONAL MAIL '� GPO: 1975-0-591-462 W t _Q. RECEIPT FOR CERTIFIED MAIL SENT TO STREET ANO N0. . P.O., STATE' AND. ZIP CODA i Aw POSTMARK OR DATE RETURN Shows to whom ehd date dellveratl Grp 7.. With restricted dollvery -- RECEIPT FOR CERTIFIED MAIL } p�" {' 1 RECEIPT 2, SENT TO POSTMARK !/ ` SERVICES RESTRICTED DELIVERY... OR DATE 4 SPECIAL DELIVERY PS Form (extra fee required) • ••- • ••- NO INSURANCE COVERAGE PROVIDED-- STREET AND 140. (See other side) Jan.1976 3800 NOT FOR INTERNATIONAL MAIL y1 GPO: 1975-0-591-452 and where delivere SERVICES P.O., STATE A ZtDE SPECIAL DELIVERY (extra fee roquired)... ............... ....•........... With restricted delivery . OPTIONAL SERVICES FO ADDITIDNAL :EES an.19763800 Form NO INSURANCE COVERAGE PROVIDED— Jan. (See other side) RETURN . Shows to w oln anti- date dellvared ......� With re5trlcted delivery RECEIPT GPO: 1975^0-603Bf-452 2, Shows to whom, date and where delivered V S7 GPO; 1975^0-591-452 SERVICES With restricted delivery RESTRICTED DELIVERY . .----- _ --------,. SPECIAL DELIVERY (extra fes required) •• • •••••• •• .•••••• F -i PS Form 3800 NO INSURANCE COVERAGE PROVIDED— Jan.1976 (See other side) NOT FOR INTERNATIONAL MAIL ti} GPO: 1975-0-591-452 W t _Q. RECEIPT FOR CERTIFIED MAIL SENT TO STREET ANO N0. . P.O., STATE' AND. ZIP CODA i Aw POSTMARK OR DATE RETURN Shows to whom ehd date dellveratl Grp 7.. With restricted dollvery -- POSTMARK , } p�" {' 1 RECEIPT 2, Shows to whom, data and where dillWarad 0, A !/ ` SERVICES RESTRICTED DELIVERY... With restrictod delivery ..... 4 SPECIAL DELIVERY PS Form (extra fee required) • ••- • ••- NO INSURANCE COVERAGE PROVIDED-- 4 •-�_ ��.� (See other side) Jan.1976 3800 NOT FOR INTERNATIONAL MAIL y1 GPO: 1975-0-591-452 a) w1h« 04 z r�« PA") 01)ipp w�l 46 z RECEIPT FOR CERTIFIED MAIL G ` SENT 0 * POSTMANK OR DATE ST ET AND N0. POSTMARK , - OR DATE STREET AND o c l 0, A P.O.. TATE ANk CUD r OPTIONAL SERVICES FOR ADDITIONAL FEES 4 RETURN !tows to- w�aorn and dita dellvortd RECEIPT With restricted delivery , to rvestrnaled�dellve e and where delivered SERVICES F- 4 •-�_ ��.� With RECEIPT With restricted delivery .._ 2, Shows to whom, date RESTRICTED DELIVERY2. .,- . and where delivere SERVICES SPECIAL DELIVERY (extra fee roquired)... ............... ....•........... With restricted delivery . an.19763800 Form NO INSURANCE COVERAGE PROVIDED— Jan. (See other side) NOT FOR INTERNATIONAL MAIL GPO: 1975^0-603Bf-452 RECEIPT_ FOR CERTIFIED MAIL _LENT TO [ ` ry. !rr POSTMARK , - OR DATE STREET AND o c l P,(I., 4TATJE AND ZIP C DE f1 4 OPTIO A SERVI FOR ADDITIONAL FEES RETURN t- aws to whamAnnd e�tr a{verad .,.,fjjj RECEIPT With restricted delivery .._ 2, Shows to whom, date and where delivere SERVICES With restricted delivery . RESTRICTED DELIVERY .. S SPEOIAL DELIVERY (extra Fee re qui red•.• ................... rm 63800 (Sea other side) Jan.PS 19797 NO INSURANCE COVERAGE PROVIDED - NOT FOR INTERNATIONAL MAIL S7 GPO; 1975^0-591-452 RECEIPT FOR CERTIFIED MAIL I�)4 POST MARK SENT TO OR DATE STREET AND NO ` , 5 — 2,0 P.D., STATE AND ZIP C OPTIONAL SERVICES FORAODITIONA FEES RETURN f• Shows to whom and data delivered - e With restricted detivorV RECEIPT 2• Shows to whom, date and where delivered SERVICES With restricted dallvety ._. RESTRICTED 2EL1VERY_ ... _. SPECIAL DELIVERY (extra fee required) ' PS Farm 3800 NO INSURANCE COVERAGE PROVIDED— (See other side) Jan. 1976 NOT FOR INTERNATIONAL MAIL {T GPO: 1975-0391-452 M 1 Q z 0 z cf-,,) ,...I ICT ( z RECEIPT FOR CERTIFIED MAIL POSTMARK OR DATE STREET ANNDD NO7 - tar P.O., STATE AND ZIP CODE OPTIONAL SERVICES FOR ADDITIONAL FEES STRE AND NO. RETURN 1. Skews to whom ped data dalTvsro .......... With restricted delivery RECEIPT F� 2, Shows to whom, date and wham dtRvered SERVICES With restricted delivery ... Op -0-A_ L SERVICES FOIL AdA1TIONAL FEES ,! RESTRICTED OLLIVERY SERVICES With delivery to addressee only S SPECIAL DELIVERY (extra fee required), .........••• •••.•• DELIVER TO ADDRESSEE ONLY ..................................................... liOE J SPECIAL DELIVENY (extra fee rrqulred) -- ...... PS Form 3800 NO INSURANCE COVERAGE PROVIDED— (See other side) Jan. 1076 NOT FOR INTERNATIONAL MAIL �7 GPO: 1975-0-591-452 RFCFIPT FOR CERTIFIED MAIL -30e (plus POSWO) SEN POSTMARK ON DATE q.V 1, ewe to whom) 114 data allvarr STRE AND NO. •ND P.O., STATE Zn CODE A Op -0-A_ L SERVICES FOIL AdA1TIONAL FEES RETURN 1. Showa to whom and date dallvlTad isd RECEIPT With delivery to addrasses only 65¢ Z. Shows to whom, data end where dellvared . 35¢ S SERVICES With delivery to addressee only S �s DELIVER TO ADDRESSEE ONLY ..................................................... liOE J SPECIAL DELIVENY (extra fee rrqulred) -- ...... PS Iran ____ Nn INSURANCE COVERAGE PROVIOEO-- (See other side)' Apr. 1971 .... NOT FOR INTERNATIONAL MAIL * CPO: 1974 O - 551-454 �Ttil AL ERVICES FOR ADDITIONAL FE _ q.V 1, ewe to whom) 114 data allvarr RECEIPT FOR CERTIFIED P.O., STATE AND ZIP CODE MAIL K :SSEN7TT:O2� SERVICES With restricled detivery _ S POSTMARK OR DATE �s PS Form NO INSURANCE COVERAGE PROVIDED— (See other side) 3800 Jan. 1978 NOT FOR INTERNATIONAL MAIL �} GPO: 1975-0-591-452 SERVICES With teslricted delivery - RESTRICTED DELIVERY .. . -.. SPECIAL DCLIVERY (extra fee required} - STREET AND NO. \ '1 1 ? IPC E P.O., STATE D ZIP-07) �Ttil AL ERVICES FOR ADDITIONAL FE _ q.V 1, ewe to whom) 114 data allvarr STREET AND P.O., STATE AND ZIP CODE RETURT With restricted deiiveiy .. 2. Shows to where, date and where delivered K `tea SERVICES With restricled detivery _ S 1' RESTRICTED DELIVERY . _. _...... SPECIAL DELIVERY (extra far required) ...... •..•, PS Form NO INSURANCE COVERAGE PROVIDED— (See other side) 3800 Jan. 1978 NOT FOR INTERNATIONAL MAIL �} GPO: 1975-0-591-452 00 00 `-;zr 0-0 6 z r- -r-4 G z z RECEIPT FOR CERTIFIED MAIL SENT TO / POSTMARK OR DATE STREET AND P.O., STATE AND ZIP CODE r Z,�� +�1� OPTI�VICESADDITIONAL FEES RETURN I. Shows to whom And date delivered With restricted delivery -.... �eI RECEIPT 2• Shows to whom, date and where delivered SERVICES With teslricted delivery - RESTRICTED DELIVERY .. . -.. SPECIAL DCLIVERY (extra fee required} - " 1•nrm3$00 NO INSURANCE UUVLHAGt rRUVIUtu— (see other side) Jan. 1978 NOT FOR INTERNATIONAL MAIL * GPO: 1975-0-591-452 RECEIPT FOR CERTIFIED MAIL �G SPOSTMARK ENT TO �/�J✓(�' ), f OR DATE STREET AN¢ 140. j P.O.. STATE AFN Cr- t • -" Q OPTIONAL SERVICES FOR Ao01TI01IAl FEES RETURN 1, sinews to whom and Ms de Ivoreal With restricted delvary RECEIPT .. 2. Shows to whom, date and where delivered e,► 001 = r SERVICES With restricled'delivery .... RESTRICTED DELIVERY .......... ...... 0 SPECIAL DELIVERY (extra fee required) .••... . . I PS Form 3800 NO INSURANCE COVERAGE PROVIDED— (See other side) Jan. 1978 NOT FOR INTERNATIONAL MAIL yx GPO: 1975-0-591-462 RECEIPT FOR CERTIFIED MAIL j irOSTP.'1riHK SENT TO OR DATE STREET AND NO (- rr". { P.O., STATEP0 ZIP ODE A OPTtoNAL SERVICES FOR ADDITIONAL FEES 1. bnwI to whelp Ind date delivered RETURN With restricted detively RECEIPT 2• Shows to whams, date and where delwered SERVICES With restricted delivery - .. RESTRICTED DELIVERY ... ......- SPECIAL DELIVERY (extra fee required) ••• •• • PS Form 3800 NO INSURANCE COVERAGE PROVIDED— (See other side) Jan. 1978 NOT FOR INTERNATIONAL MAIL GPO: 1975-0-591-452 RECEIPT FOR CERTIFIED MAIL SENT T0' POSTMARK ✓�� -OR 31 l E" ca~, STREET A N0/,/rOG yp % POSTMARK �. P.O„ 5T AN(l f CDDE N ! 976/ TIONAL SERVICES FOR NOWONAL FEES 1. owS 19 wham and date delivered r ., •. RETURN With restricted delivery _.._ _1� RECEIPT 2• Shows to whom, date and where delivered SERVICES With Mtrir.Wd dalivary ..,..... In • RESTRICTED DELIVERY ...... $ P STATE AND SP£CW DELIVERY (extra fee required) •••.•-•• -- • •- • •--- 1Z PS Farm 3800 NO INSURANCE COVERAGE PROVIDED— Jan. 1978 (See other side) NOT FOR INTERNATIONAL MAIL {:r GPO: 1975-0-591-452 RECEIPT FOR CERTIFIED MAIL S T TO P STMARK co A DATE STR ET AND N0. � J% P.O., STATE AND ZIP ODE t a !O ' ESER 10 5 F iR AOfliTIDMAL FEES RETURN I. Shows to whom and date delivered ,.,....., RECEIPT With restricted delivery __... --- 2. Shows to whom, date and where delivered SERVICES With restricted delivery l ,� • R£STRICTEU DELIVERY �/ I Q SPECIAL DELIVERY (extra fee required) .......... .................... ti PS Form NO INSURANCE COVERAGE PROVIDED— Jan. 19763800 NOT FOR INTERNATIONAL MAIL (See other side) GPO: 1975-0-591-452 RECEIPT FOR CERTIFIED MAIL T TO % POSTMARK 08 OATE (7) P STATE AND or V-��Of} oNAL SER ICES FOR ADDITIONAL FEES RETURN RECEIPT 1• Sows to 1lrhom anG dale deNvered ,......... With restricted delivery ,........._ .. SERVICES 2. Shows to wham, date and wh"' delivered With restricted delivery . ., • RESTRICTED DELIVERY.,....,, 0 SP£CIA1 pELIVERY (extra fse required) •. ..-. /►7-1 PS f=orm Jan. 19763800 NO INSURANCE COVERAGE PROVIDED— (See other side) NOT FOR INTERNATIONAL MAIL ' GPO: 1975-0-591-452