(3870.) 
Administration of the United States. B. 
RETURN RECEIPT. 
AVIS DE /RECEPTION^ 
for a registered article _;_ ) fl) 
d’un objet recommandd _) (1) 
EAST SIDE STATION, the JAN 15 4i_ ill _ under 
...J^EQV.UQ£N~^ ' 
and addressed to 
et adresse a M _ 
au bureau 
_o^i ' t 
de 
Stamp of the ofiiee..GLiJeIivery. 
Timbre du 
(a), 
The undersigned certifies that a registered letter to the above address and 
Le soussigne declare qu’un objet recommande ii l’adresse susmentionnee et provenant de 
_ has been duly delivered_ r the _ , 190 
a ete dument livre _ le _ j _ , 190 
SIGNATURE (3) 
(l) Nature of the article (letter, sample, print, ete.). 
ir,oi. 
(l) Nature de l’objet (letter.Ijehantillon, imprimfi, ete.) 
of the addressee 
du d^stjnataire: 
-A' 
delivery: 
( 2 ) Office o£ origin; date of mailing at that office; No. of entry at said office. 
( 2 ) Bureau d’origine; date de d6pot ace bureau ; No. Penregistremeut au meme bureau. 
(3) This return receipt must be signed by the addressee; or. if the regulations of the country of destination permit it, by 
the chief of the office of delivery; then placed in an envelope and transmitted, under registration, by the first mail 
to the office of origin of the article to which it relates. , 
(3) Cet avis doit etre signe par le destinataire ou, si les reglements du pays de destination le component, par le chef du 
bureau distributed:, puis etre mis sous enveloppe et envoy6, sousreeommandation, par le premier courrier.au bureau 
d’origine de l’objet yu’il ooncemc. 6 — 4172 
