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i <br />~ ~ SENDER: <br />~~ lete items 1 and/or 2 for additional services. <br />lete items 3, 4a, and 4b. <br />d card to you. <br />p ~~•• your name and address on the reverse of this form so that we can return this <br />> •Attach this form to the fron t o f t h e m a i lp i ece, or on the back if space does not <br />~ permit. <br />«~ Write'Return ReceJp~ q~quested• on the mailpiece below the article number. <br />The Retum Receipt wiil show to whom the article was delivered and fhe date <br />~c delivered. <br />d 3• Article Addressed to: I <br />a ERIC HEINLE <br />0 563 COURT STREET NE #2 <br />" ~ SALEM pR 97301 <br />W <br />~ <br />0 <br />~ *P528201246** <br />F 5. Received By; (p~nt Name) <br />W <br />~ <br />a 6• S~ature: (Addressee o~Agent) <br />~ <br />= ~ <br />Ps For"' 38y 1, pecember 19g4 <br />~11~~~ ~ <br />~11~ ~~1111: <br />~' ~ <br />~,,,, <br />_~~.~. <br />I - <br />140300 <br />Marion C°unty <br />OREG~N <br />GENERAL SERVICES <br />~ <br />~ r <br />1TO ~. <br />Suite 5321 ~ sale ~ ~R ~~3Fk ' <br />100 High Street NE ~y ~ ~___,\_~~ <br />r~.~~'~.~t~F~fr <br />~~''~~ a9t ~ ~ ~ ~ - ~ <br />~ ~7'~ b~~ ' ~~'~", '~' • <br />" ~ ~ R~ ~ i o~ ~ ~87k ` ' a <br />~F tlSr~ ~.,,'-.,,~ <br />I also wish to receive the <br />following services (for an <br />extra fee): <br />~ • ^ Addressee's Address <br />2• ^ Restricted Delivery <br />Consult postrnaster for fee. <br />782144 <br />4b. Service Type <br />^ Registered <br />^ Express Mail ~Certified <br />^ Retum Recefpt for Merchandise ~ Insured <br />7. Date r,f ne~,.,,,... O COD <br />and fee is paid) <br />~ <br />n, <br />. ~~~ <br />~..s_:. <br />Y <br />.~ <br />~ <br />a <br />_~ <br />~ <br />~ <br />_ : <br />~ <br />¢ <br />rn <br />c <br />~ <br />~ <br />`o <br />~ <br />O <br />~ <br />Y <br />c <br />R <br />H <br />~~. -'~"~ ,~ ri.~'a-~, _ ,_ . <br />~ R EIP~ ~ ~ , <br />RETtfi~~Rl ~.: ~ <br />f3.ES~; ~"~;~~ ~ ~ 3 ~ ~ ' _ ~' ~ ~. ~~ <br />~ ~ A~~ ~ ~ -} ~ <br />C C~` I F~~ _~}~~`~-~ ~ ~ <br />~ L ~ ~ <br />No. ~sal~ (~ _~,~` <br />I ~ <br />~,~ A 1 ~ <br />~?~~. <br />ta D E <br />r ~ ~' ~ <br />STREET NE # 2 ~ ~ ` <br />~ ~ 97301 ~~i~~ <br />~ ~r~;,,~_ _.. `_+~~~'_--~ <br />~C 'i:~ ~~~ ~ ~ 1t~, ~~~~.. <br />.,~~ '~+~ <br />' `'~~~ i~ ~ ~.. <br />QRYe/p~ <br />~,s ~-f'h_ ~---'~r~~-e''~ `~ <br />~~ <br />~~~~ei~e~~jti~~~~t~~i~yi~~t~~~ift:t~~e1~!~~~~ii~~::i:~~s~~~~~~ <br />:; „f . -t <br />.:r, " ~ ri~ Y. - ~ <br />