UNIVERSAL POSTAL CONVENTION-WASHINGTON. JUNE 15, 1897. 17 ()7 A, Form A. R L A U S A N N E . N·· 1460. B. Form li Return receipt. Administration of ... . ’ RETUBNRECEIPT fvr it letter with declared value of . . . . Eentered at the office for a registered article ( ..,,,,..,,.,,,,.., ) (1) ,_,,,,_, of ·--·-. . . the . . -.under Ne. Q . (2). that a letter with declared value The undersigned declares gte the above-mentioned I 5, p of me that a registered article ~ cfu of delivery_ address, and originating at - ...,.. has been duly ; I delivered ... . on the 189. ,. I I Signature (3). I I 3 of the addressee: nf the chief of the ojlu of delivery : I ````````‘ ‘ ````"``'"``°'`'````‘``'°```'``‘````'`"````‘` I
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I (1) Nature of the article (letter, sample, print, em.). I I (2) Office of origin; date of mailing at that ofllce; N0. of entry at said olllce. l (3) Note.-This Return-Receipt must be signed by the addressee; or, if the regulations of the country of deetination permit it, by the chief of the ntnce of delivery. then placed in an envelope, and transmitted, under registration, by the drst mall to the office of origin of the article to which it relates.
