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• Complete items 1 and/or 2 <br />• Complete items 3, and 4a <br />• Print your name and addre: <br />return this card to you. <br />• Attach this form to the froi <br />does not permit. <br />• Write "Return Receipt Reqw <br />• The Return Receipt Fee will <br />to and the date of deliverv. <br />F?ddtiio`'naYsg 'cek. ' I a" to recei e the <br />?_foJlowi'-"-sarv° e?.If? o an extra <br />D AA _ _--? --='- - ? <br />on the' reverse of? his form so tHat-we'can __fee rJ <br />t of the3,eilpiece, r on the back if:_space--?- Add[HSSee'S ?Address <br />Jm.? - <br />? -?--- -?.. <br />st oft?fratMnailpiece below the article number. .. 2. El ReStriCted DBIiMery <br />rovide he signature of the person delivered <br />Consult ostmaster for fiee <br />3. Article Addressed to: <br />Mr. Richard G. Hunsinger, P.E.P <br />_ CC Dept. oL Community Service;s, <br />Sanitar_y Engineering Div. ' <br />6100 W. Canal Road <br />+ Valley View, OH 44125 -, <br />P <br />4a. Article Number <br />P 619 718 132 <br />4b. Service Type <br />? Registered ? Insured <br />15 Certified ? COD <br />? Express Mail ? Return Receipt for <br />Merchandise <br />7. Date of Delivery <br />5. Signature (Addressee) <br />6. Signature (Agent) <br />8. Addressee's Address (Only if requested <br />and fee is paid) <br /> <br />PS Form Jt371, November 1990 trU.S.GP0:1991-287-066 DOIV9ESTIC FBETIJRN RECEIPT