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HomeMy WebLinkAboutS-0351 ApplicationPS Form 3800, Apr. 1976 0 CONSULT POSTMASTER FOR FEES o b"mow m n c, co Q z o OPTIONAL SERVICES m az RETURN Aos' RECEIPT m�mi ��o SE VICE Uzi ni moo A j� v, n D 1� .,.! z'] I O m m z 0 y�� 2 0 31 r .7 �fle <^<� mo -M of n m �c�} Koh {'O� o r+�va <� ❑ r n An, Z2 =n a- 0� o n C < � < o,a ` m 1A t { x o m 1 -_ M/ Oa A A A A A A PS Form 3800, Apr. 1976 CONSULT POSTMASTER FOR FEES o ocn �I � OPTIONAL SERVICES m �� D ,� 1 m 'r 0' T _ "' � M Z z O dr URN RECEIPT SERVICE m cn mmcn mncn o<n O CO n m \. z z %O oo 4J �o ��o mm� moo mom mo o, 70 -4 a r o m m o 9�e N 0 s0 <,,,0 x 190 =Q m , v n m r O � o m mm mn n < -� T 1ln�n � n ,m<}, -K4 io z 0 o� ElW T C O O (D Z CID -4 M 77 =M c (D Z G m >m a N ZM �� r ro � o �o i M M 0 ffil -9 M 0 M M 1� cn 7� r?D _P-lb 4 oa trro rtFi o u� ro r�r o H_ 0 sz C s✓ � �V cD � r- (D (D P- H- FJ- x Pi H_ Fi N- 0 rt p •• rt rt rt (n Fi N rt F�- En n rt 0 rt rt � rt (D OU (DD rt(nFJ-(4(D PJro�m� (D �r mx((DD • O in �$ n Fi Fi (D (D 51 Fi O 03 LQ �j O �J W Sz (D P' rt �d F-J �d x ►C O Pi 0 ~ n In F-h �' 0 9Z (DP)P.F- � N 0 � F-i P) (D (n K rt c (n (n x x Fj ~ `n rt (Da P- :- �c o En w ro Ef) 0 (D V1-0 (D tj P H F_ w'-0(OD((DD 0 Pi (nWrt(OnO n Fi � �o� x N- ooccnn ct''d 0 (D t5 w Fj- (n N :j (D ' Y (D '-d V O N Lq Fi 0rt�o Glpi Fli H w aFcLQ rt cn o a w o a (D cD (D c 'd 0 Fes- w • �va pia n n H ~'' Pi m rt � F-h N Ooh"z tort � Pi D (O0)rt P)rtl<� tj0�v �J �V• (D (n (D (D P- 0 (] H. In rt � rt 0 (D o W 0 Fi H (D W ' FJ- (DrOt0 In n�(DFj :d (D (D (D 0 F-' no 0�3' �t rt P- O (D F� :j �v 0 En w N Pi (D (D rt F-< U] In (n �r o r. x rt O00n w Fi rr Hz � (D C) FJ• 0 O (D rt cD w 0 N O A A O 0 W S D O � O 0 W a I Oi Ld f G, rs o P b J. 0 O w v V A -• O O r� N 9 r ft 0 n C7 ff• (D 0 Fh r� (D 0 ft 0• ti] x (D 0r rZ rt O a O (D Pi pi rt (D UJ tr (D n (D N� w It rt, n En rt It 0 n rr tr 0LO � (D Pi H th t0i cn P) O UI• � tEj n O 10 z trl O N It Fh En x 0• r• (D n o 0 n in P. r• � N � a O N (D n � w 0) Fa tJ' � N G W (D mmH IU] Y. 0 Fh ft U) td N F.1 0 Ffl N N G �i a 0 (D L-i 0 rt N N 0 0 Lrl H m r 0 tr a rt rt m V)• 0 a- a �• rr �C pr 0 0 F'• f) Fh O �C p) (D 9J' (D Pi F'• �S a a F. (D Ill �l (D0 ft pi ti fi• 0 H ;1 w Fh F'• 0 0 ;r O P. 0 a o a P• ° Pi � n `t 0 c 0 O tQ v F� a 0 f2 Cry 0 : t i Fh (D . fi N U7 rD C P. o (D m (: a fu 1-3 a (D y V w z O N w (D 0 < �l tj En 0 O 'J x ! 6 ;d (D (D (D 0 rt Ul rt rt a� 0 (D N e'i (D ti P. (D 0 (D N 0 rt rt pl S) (D fi H- (D G O 'U P• - tr t3 (D Or Fh W• (D 0 ; 0 (D (D (J (n 0 U] H a , LQ (D ! O 0 h rt H �r rr a 0 x O lZ a I �' N (D 0 .(D 0 (D W (D ; w N• W 6L �+ Fi i SL x (D a !-' n 00 0 (D F+• N• (D !-h a F•' (n -! O• ti N. O t7' 0 O Ki N P. . 0 W �R Ili ti � ai Fi W N• o-h (D N :v pi (D 0 is W N 0 ►d rt 'w >fi a rt Fi a � w a o• rt (ND a ((DD n (D F'• LQ �3' 0 n > b w ro rt P) 0 a (D h C u; O P) rt 0 1-0 LQ (z rt N N K LQ (D N td h rc (D tr % P) (D a °c a 0 N O ro rh a rt w :3: x x N• O' N 0 rt 0 0 F'• N O rh tr ri v 0 ti a (D fD N ^. � ui o• Lq FOn H n a On u; (D (D 0 i7° rt, W 0 �• y tr w (D O 0 0 N 0 P) td ft � En � � O' N rt rt O 0 10 (n O' F'• re 0 ri En 0 0 �31 (D N A� ►ii F'• p% x 0 (n (D m lfl � Q P) rt (D Z I 0 (D F•• rn (D .. LQ (D :7 N Fh f i , p� a O O 6v En � (D (D rf ft (D a N 0 rt U7 er m (D (D n rt 0 Fh O (D (t rt 0 0 O rt � x t�7 c C �y CIO y+ O Fh fi r¢ � O Pi r* o C7 � Cn (D 0 r U7 �q �W z ' y � l� [In CID M c ' n t7 l ;-rl ey c O O. Q i I� 1` lk 41 Pi rt O h I 5 rt- rt H O m r j ® o 0 N rt O K a rt O L C- f i r , j ! V lA rip III •N�� o l c 4'`` k W V P) a 0 a 0 Z 0 0 0 :3 0 fi n ri ri Fj K ,.� rt �l 0I f- 0 0 ; c r4 p�� S c r.� c �. P11 5684 RECEIPT FOR CERTIi I NO INSURANCE COVERAGE PI NOT FOR INTER NATl0NAL sENr ro (See Reverse) STRC� 1V `14�1 a�anlflr a4i i pli!ii6l+c —1 mit0 FEF m H t' O x FJ• n(D ¢i rt �3- (D rt cn in U) rrr (D � (xD (DPi0 4 q2 ^: 0 m U) N (D E 0 H W a (D H- � �(��o� �> O H ct pi, v in O �s C� z 6z ortm5F-pirt > n W �J �V rh m Pi n �V (n Cn (D In (D (D O a - `H- x �rl (n a n En v n 0 �0'� n 01c � 5 a w(Do F� (t ry [n I-h W O ,A 0 'b ti n Pi rOr°N-0))P� J 0 0fi0 rnt kl (D h FJ- Fl- PJ n fD ¢ rh O (D A� O ¢'Pi n Fj- H O Lr=J Fes- P+ PJ F- rh'O u OFl O q F-' F1 Pi PV F�- PJ rt�� Iv � En n y W 0 P 0 ((DD a H F- (t b" }` O at-h a(na0 � a P) r rr (t (D Fz; rt rt n � (D "d Ct ((DD (D uul �LQ a 0 [n O (t Fi N• I y1 J r ` i a P t 0 a+ 0 I (°c n 4J n a rt O n ti n a ti ct rt 0 0 r' *�