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Z-9432 Application
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CD a �°d p o CD o CD �3' CD `�° �' CD O o ° O r. o °, o � C) CD O O O CCD CD p bi N CD ' i=- cD CD O N MEn p Q rii O ¢ '� p `C O CD �l o 00 C '_ -0 d C �J" M G fD CD C CD UQ � CD �—j fD• � CD O CD (D tom. C ° Cy• Flw o� �voy p n o ro o ro w O co ti o o o kA tr- �o o� N O�oZa " o ti o ©• n n y O9. Otv) O� v o a y !tt b '.b oho ti .b y coo %b b Cq cNi, iV N n � b -ii�tH�iVNV--------=-- N IN04Y 000muId m m r- ro Ir f- Er 1� 0 0 O m CIO CO 0 N .orldied Mail Fea M —44, [] Return Receipt (hardcopy4t&0 ImReturn Receipt (electronic)Certified Mall Restricted pSAdultsignature RequiredS Adult signature Restricted5 _ Certified Mail service provides the following benefits: ■ A receipt (this pardon of the Certified Mail label). for an electronic return receipt, see a retail • A unique Wtvifier lof your mailpmu. associate lot assistance. To teCGYe a aupkala • Elacbanlc vildlicatlon of aoiivery or ottampled return receipt for no additional lee. Aroseni this delivery, USPS9-posllnarked WHIM Mail mcolpt to um • A mCefd of dofivpry pix:iudin ale fact 0AN signalurel drat Is relaiW. ll;y Um Posq Servij"- retail auct'laia. ft-50 tcd delivery sefvlde, wiliah provides tar a specified pP1 W. ; d otavaty to IN addrlsaea specified by name, or ' - to of a iddressee's authorized agent RRporfallf CRI1FrIB15: - - "y"Ult signature service, which requires the ■ You may purchase Certified Mail service wlIll sfgnee to be a[ loa5121 years of ago (nol First-class Mail", first -Class PZIEWIN servlae°, a'*talsld al relaill, ON Pnatity Mail, semco: Ad nalun restricted delivery service. which • Cerllllod Mall serviceJis not&lble for ri:t uW 04 ate signed l0 ba at least 21 pats ui age Iniamallomd mpll. •• and provides dNivery In tree addresser; sPacirted ■ Insurance coverage Is not available for purchase• by name, or to the addressee's authorized agent with Certififtyail service. However, the purchase (not available at retail). of Cemlied Mall sdreicu aee3 not cdanpa lrtu . To cnsum pia[ your Carlifivo Moil Pucelpl is Insurarce coralm4o auioinatically included with accepted as legal prohf of mailing. It should hear a Cor[aln PrWtliy Mailllems. .l)SP5 postmark If you WWid like a pdstmalk on a Fur art additional fea,'eild wjlll a phrpar' - this cilmlied Mall rotewl' Piaasu present your erldorsunl l On She IrlailplEC y3y Legit ai *' Cort lud Mali Item at a Past Ofbce lot the following srrYiGas ' poslniarwrig, If you don,I need a Posbnark an this - Illnum rocoipt ssvvicn, welch provides a rotm al Cartihcd Mal receipt, detach the barrAed padim of dehvely tmcfuding IN reciplonttr Signatum), 01 Ihia label, a0i>r it to the mabpteec, apPfy Yea CNN r04=10 hardoripy Wlira mealllt 0f all appmpriato posu4u. and depopt the Illaifplece- electrdllic ver:lOn. Fora ttardnopy reWrn receipt,, tom pluta PS Farm 3a1 t, A)plesdc Rclum Receipt; attach PS Farm 3011 to your mailplece; IMPORTANP Save this receipt for your records. PS Form 3800, April 2015 (Reverse) PSN 7530-02-000-9047 rq m Ln ru rq t3 C3 O 0 rq r- rq 0 r- xtre Services A fans (CIMck bee, ddt ❑ Retum Recelpt (herdeopy) $ ❑ Ralum Recelpt (electronic) S ❑ Certified Mall Redrlded Delivery S ❑ Adult Signature Required $ ❑ Adult Signature Rosuictad Delivery S prrpdera : 3 2019 Postmark Here L406-000-ZO-OeSL NSd (asienaW SLOZ IudV'UUBg =0:1 Sd ,sprosar LnoA iq ldllw 91LB GALS 1NVAOMI •aoald!!ew u41 nsodop pue'a6Ljymd anlydnxlde A]dde'a37!d1!ew a41 o)11 xWe'laWl pn le uoplod paponieq oqy rpuulp •Id!aaal pelt' po!puaO 2141 uo xlewlsad a paau pop no it -Oupiewlsod A JaWO IsOd a 1e wall IIeW PaulUa3 moA luesaid aseald'Idloom peW pau!uao slgl uO xleugsod 0 axll pinoM neA q slrewlsad S sn e jeaq ppwgS 11'6uulow 101oon1 lu6al se pa1da33u 81 yd[a3or Heft' PamPMj moA IBL l OnsnO al s '(IIeIBI 1e algallene lou) lue6e pazpoglne s,aassaippe a41 of io'eweu Aq pallpads oessaippe a4l of Aranllap sapinmd pue of to —A Id isua! le Ol W oaufi!s a41 503106w 4OILIM `03Nuas AroMllaP P'OJJJsol a1nl0ufils Ilnpy - fuelai )e algepena loci] du W s-A I $ Isea! le aq o) taO3 041 1*J!nbol 43]gM'O11N35 ON114iusp 11nPV :a3aldllew moA of I IB£ uu0.J Sd 40elle ydlaoay urn)ay 3psaru00'I Ig£ wmj Sd ololdwoo 'ld!o3or umla) AMo3pn:4 r, lU'4afshm 300g3®lu ue w Idima1 bul!niAda3pmq a IsenWi ❑e0 sM •tainleu6p s,luoldpm aqI 6ulPnRIIII ija?,u p 10 Mma1 a sopf" ip iq%'M[mh s Id"i wlq�,q - ,s63pVa:: olpwillpl I141 )sanbai Aew noVe3aldllew 041 uo Iuawa510plla jadold a IIIIM pue'aal Ieuoplppe ue iod ■ sulall IIeW 14p0ud elell83 g11M pan N! 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Id!am V a :sli;auaq iSUIM01101 0141 sapiAoid eoiMos liew paigpeo CO N a ti 0 0 0 0 Ln s N a O r- Certified Mail service provides the following benefits: ■ A receipt (this portion of the Certified Mail label). for an electronic return receipt, see a retail + A unique identifier for your mallpleca, assedatu lot assistance.lu fecaive a duplicate ■ EIKUwk vcri8catlon of &lWery or attempted return receipt for no addlliorlal fee, present this deli ary USPSO-Wirr6wked CerliiRed Will mcvipl to 114 ■ A fecurd of dollvery (maluding the redptenit stgl+ature) Illat is retained by the Postal Service" Wall assectale. - Restricted delivery sorvico, which provides lot a specified ponod, delivery to the addresses specified by name, or to the addtess ev authorized agent. Important Reminders: r You may purchase Ca010 Mall svrvlca with First -Class Mail®, First -Class Package Service°, or Priority Mail' service. ■ Certified Mail service is not available for International mail. ■ Insurance coverage is notavallable for purchase with Certified Mail service. However, the purchase of Ccrblred WLservrco does not etuurge the instuarice ciovcrago aulornaltcat[y Iriduded with Wain Prinnly Mail lours. ■ For an additional fee, and with a proper endorsement on the mailpiece, you may request the following services: - Return receipt service, which provides a record of delivery (including the recipient's signature). You can request a hardcopy return receipt or an electronic version. For a hardcopy return receipt, complete PS Form 3811, Oomestic Return Receipt,' attach PS Form 3811 to your mallpiece; Adult signature service, which requires the signee to be at least 21 years of age (not available at retail). - Adult signature restricted delivery service, which requires the signee to be at least 21 years of age and provides delivery to the addressee specified by name, or to the addressee's authorized agent (not available at retail). ■ To ensure Ilim your CsWrrod IAail receipt is accepted os legal praol of maiting, it silould bear a USPS postmark it you would like a postmark on this Certified Mall receipt, please present your Certified Mail item at a Post Office" for postmarking. It you don't need a postmark on this Certified Mall receipt, detach the barcoded portion of this label, affix it to the mailpiece, apply appropriate postage, and deposit the mailpiece. IMPOFMAN1: Save this receipt for your records. PS Form 3800, April 2015 (Reverse) PSN 7530-02-000-9047 r a ru rq 0 0 0 0 Ln rq N rq 0 r- Certified Mail service provides the following benefits: • A receipt (this portion of the Certified Mall label). for an electronic return receipt, see a retail • A unique Ideollflar far yaw mmiptuce, a5.40Clate lof as:e5lan x, To receive a duplicate • Eeto anic veriflCatlon of delivery or attempted retul rocelpl for no additional lea, prssedl0ft delivery. USPS0-postmarked Cerlilled Mail lecelpt to the ruind associate. A racard OF dellvaly tirx1 udifn21110 faCipicnl's 51ga.lufe) trial is retained by die Postal $01Wce` ter a specdied ja--O 1Rrpdrfant Remlwers: n You filmy purchase Cerlifled Mall ser*u with Ffs Class [deli¢, Frsl-Gass Package Service', or Priority MOdr service. ■ Cedtued MM riervlce is notavailable for international moll. • Insurance coverage Is notavatlable for purchase with Certified Mail service. However, the purchase 0f Cornfield Mall ServlCe does f101 ChanU0 the Insurance coverage automatically Included with certain Pfiefity M ul Iterm. • Fur an addilanal ICE, end vAh a propel endorsement oriop mallpiece, you may request the leltowmg svrvlces- - fielurn receipt serAre, which provides a fmwd of dellvvey tincludino the rodplents signature). You can Iequast a lialdaopy return re"111%or an elacuonle ve:slon. For a hardcopy retum receipt, complete PS Form 3811, Domestic Return Receipt; attach PS Form 3811 to your mallpiece; f e--M ted de110ry SeNW% which provkles delivery to Iho addressoe spaciflad try name, or to the addressee's outhorized nganl. Adull dgualure service, which requires Sho sllpw to be a1 least 21 Voom of age (nut available at fel01j. Adult slgrualwe reshicWd delivery yervlee, whidi m ,quIfes Iho sagnue to be, al. 1" 21 ynm of arse and provides delivsry to We addiessn specftd by name, or to the addressee's authorized agent (not available at retail). ■ To ensure that your Certifed Moll roceipt Is accepted as legal picot of mailing. II should bear a LISPS IMMI;ok.11 you would like a po3um fk tin this ceihfied Mall lecelpt, µh asc pruaxllt yulfr Certified Mail Item at a Post Office" for posimarking, II You don't need a postmalk an Ihls Curtitued Mail recalpl, detach the barcodod portion Of lies label, allix it 10 the mailplece, apply appmp[Win poslaqu, and dapnsil the raWlill U. IMPORTANT: Save this receipt for your records. PS Form 3800, Apni 2015 (Reverse) PSN 7530-02-000.9047 r- a Ln rl ru rq 0 0 0 0 Lrl r- rq 0 r- Certified Mail service provides the following benefits: ■ A receipt (this portion of the CertlRed Mall label). for an electronic return receipt, see a retail • A rn Ique identifier for your maflp:eco. assaclate Inr assistnnca. To recc,ve a duptcale • ElacbaniC vedficafion of detvery ar atleomted Felton rocelpt lot no additional lee, present Him ddlivcly. USPSO-postmarked Certilied Mad iecefpt to IN rclat associate • A record of deavery ynEwing nkr racipfonrs sigmure) Ihal is retained by 1he Postal service'" for a SpeziTW lienad. lmportfant Remlarlers; • You may purchase Certilied Mall service with Flrst•CIaSs Mall First. Class I'a�katle Serviue', or Ptlorlly Moll *Mko. • portiflud Mail s ACv. is notavallabia Inr intmnatunal mall- ■ -Insurance coverage is notavallable for purchase with Certified Mail service. However, the purchase of Gerlilied Mari service door not clunge the Irmwanco covoAije mlomaticatly included with cellain Pfirinty, Mail Items • Por an addltlorlal In, and with o proper endms4mwit on the midlldeca, you may request U, (ollo iog Services: - Waco receipt seivlce, which provides a record el delivery (Including tho reclplent's sigrlaturel, %J can request a hardcdpy futurh recdlpt or an 1:1 ctnank urrs101. Par a dardcopy rolurn receipt, complete PS Form 3811, Domestic Return Receipt; attach PS Form 3811 to your mailplece; Reshictesl delivery scrvic%which provia-3 delivary to the addres5cw spacilied by acme, or to the addressee's aullterizeil agent. - Adult si8naturesuvic%which requires fhe signee to be at least 21 years of age (not avalfable at rCWQ. Adnfl signature msirictdd delivery servlco, MOO requuus the sl¢nec 10 be at least 21 years of qL% and provldesdchvory to the adilressit! speclflcd by name, or to the addressee's authorized agent (not available at retail). • To ensue t1a1 your Crtrtigrrd Mall reeelut is urcepwd as legnl proof of mWing, it enould bear a USn M-Amwh. II Ku would like a posfnluik ou this Cuniuud Will F=s Pl, please present your Codified Mall item: at a Post Oftte' for postmarkhrg. II you don't need a postmark on this Coftffed Mall recelpl, delTic h the b:ucoded portion of this lakes• atl'gr it to IN matpww' apply appropriate postago, and deposit Iho nlntiplece- IMPORTANT: Save this receipt for your records. PS Form 3800, Apri12015 (Reverse) PSN 7530-02-000-9047 0 0 N ru 0 0 0 0 a N 0 r- Certified Mail service provides the following benefits: ■ A receipt (this portion of the Certified Mail label). for an electronic return receipt, see a retail ■ A unique iilenVur for your mallptcce associate for aszisianco. To receive a duplicate ■ Elemw1c, vedifcatfan ut dal.vtuy or atlampted return receipt for nu addiliunal fee, present Ihis doffvery. USPS+#g-pwimatked Ccrtlffed Mae receipt to the • A record 01 delivery pniludfng Ills rodpitml's slgnamray'nal Is reloinod by flta Postal Servlce" retail associnle - Restdcted dcdivety saMro, willch plavldas Ior a specified period. dtlivery l0 Ihn addressee spacllled by dame, or to tlho addressee's alltl101izeil agent. Importan3 Reminders: ■ You may purchase Certified Mall servlce with First -Class Mail First -Class Paekagu Service®, or Priority MailO service. • Certified Mail service is not available for international mall. I Insurance coverage is notavallable for purchase with Certified Mail service. However, the purchase of Cerl!lfod head survice does not change the inwri-mce e0vt'rage aut0m atically Included with Conant Priority Mil Ilem:. ■ for an addiBemd fore, aril Will a proper endomftent Olt Ilia maltpKuce, you may request Ilurfolid ing services: • 11Oiurn receipt service, which provides a record of delivery (including the recipient's signature). You can tequosl a hardoopy retum romipt or art electronk version. For a t i*,.opy rolum recclut, complete PS Form 3811, Domestic Return Receipt; attach PS Form 3B11 to your mailplece; Adult signature service, which requires the signee to be at least 21 years of age (not available at retail). Adult signature restricted delivery service, which requires the signee to be at least 21 years of ago and provides delivery to the addressee specified by name, or to the addressee's authorized agent (not available at retail). a To enmiV* Vial your CCrhfiP,d Mail receipt Is bceepted Ps kg'tl INOOI at moiling, it should bear a UMIS poslma k II you would Ift a postmark on this COOied Mall recclpl, please prrrwnt your Cerfilied Alan Uri at a NO office, for poMmuking.1f you iton'l rated a postmark on. this Cv-Plified Mail fecelpl, dvindi We "codeil pottfon of this label, affix It to the mailpiece, apply appropriate postage, and deposit the mailplece. IMPORTANT: Save this receipt for your records. PS Form 3800, April 2015 (Reverse) PSN 7530-02-000-9047 CoriHied Mall Fee - Simi Services & Fees fLnech Iwx, add foo e; apf#o o ❑ Retum Receipt (hardcopy) $ ! - ❑RetumReceipt (elechonlc) $ PO'SIM V 1 ❑ Certified Mall Re afflated Delivery $ + Hero 1 ❑ Adult Signature Required ©AduR Sgrwturu neWOLa6I%Wery Postage (frA Total Postage and Fees S� SentLEi n RZ �..y � {-.I'm-� r. k . 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