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~ N <br />• Comdata ilema t enNor 2 for edditicrwl serWC•a. I also wish to receive ilte <br />n .Comdata items 3, ea, aM ab. tolbwirg sefvices (for an <br />aqr •Pdnr your name end address on Ne reverse of tNa ions so~hat we can ralum Ills extra }66): <br />card 1o you. 4 <br />~ .Attach INS brm to the from of the mailpiece, a on the back it space dose nm t , ^ Adtlfessee'S Address t~ <br />~ pertnil. <br />~ eWnte'Hefum Receipr Hequested'on the mailpiece below the article number. 2. ^ Restdcted Delivery <br />« •ThB Relum Receipt will show to wham the article was delivered and the tlate <br />G delivered. Consult postmaster 10r }6e. i <br />3. Antic/le Add~r ssed~Jto; 4' rtlcle Number _ ~n <br />~ 4b. Service Type <br />~ ~x~ yea ~, <br />cat k u~ ~ ^ Registered Certifie <br />`( `w~ ~(, ~. ^ Express Mail ^ Insured .p <br />i~~~o C /~ <br />/~ ~~/~ ^ Retum Receipt for Merchandise ^ COD a <br />./(/~ ~~(~ ~ ~~ 7. Date of Delivery ~ <br />z i'~ ~ S 3 ~ - ~1 ~ i, <br />5. Received By: (Print Name) B. Addressee's Address (Only i/requested ~ <br />F' and fee is paid) t <br />f- <br />~ 6. Sign re: (Address o Agent) <br />i. )( <br />n <br />PS Form 381 t, o mbar 1994 omestic Return Recei t <br />I_ <br />e~ <br />N <br />L <br />E <br />O <br />M <br />"o <br />LL <br />a <br />f <br /> <br />No Insurance Coverage Providel p <br />~~ Do not use for International Mal <br />ISee verse I b <br />io <br />n <br />/R{~, <br />a y ~ <br />P Zi Coae ? <br />~~~ G <br /> N <br />Postage F <br />9 <br />Cen~l~ea Fee <br />Speuai Oenveis Fee <br /> E <br />R¢sii¢[ed D¢LVery Fee <br /> C <br />ReNrn Rece~p~ Snowing (rJ <br />~o Wnom a Dale C~wereo C <br />Return Receipt Snawmg ~¢'tvrom <br />' Q~ <br />s Atldrass <br />Dal¢, clod P~tlresY¢ <br />TOTAL Postage <br />g Fees <br />Postmark or Date <br /> <br />Z 416 942 CGK' <br />Receipt for ~~ffii pp <br />Certified Mail~rl'r/3/q~- <br />