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d SENDER: <br />v •COmplale items 1 endor 2 for additiorW services. 19150 wl5h to receive the <br />m •Complele items 3, 49, and 4D. fOIIOWIng S9NIC9S (for an •" <br />„ • Pdnl your name and address an Na mrorae of Ihia form ao that we can rrnum this extfa f66): <br /> <br />~ card to you. <br />•Attach this brm to the front of the mailpien, or on the batlc if space does not <br />t , ^ Addressee's Address <br />m pemtit. <br />m • Wdte'Retum Rxgrpf Requested' on the rnailpiece below the em'cle number 2. ^ RaSfdcted D911very <br /> site Retum Receipt will show to whom the ertitle was delivered entl the dale <br />~ delivered. Consult pOStm9Stef for fee. <br />O .. __ <br />d Ka~~ Y~~~~, <br />~~co-. ~Guv`~~~ <br />°~?03oX 11~ <br />SPr ~~~~~ e1d CS~o73 <br />5. Received By: (Print Name) <br />w <br />8, Siygnature: dresse orAge Q /~ <br />T V C/-! <br />_P ~'~ <br />PS Fo 3811. D ember 94/ <br />y3 0 <br />^ Registered ^ Certified <br />^ Express Mail ^ Insured <br />^ Retum Receipt for Merchandise ^ COD <br />and (ee is paid) <br />0 <br />Z <br />N <br />Y <br />V <br />c <br />0 <br />a. <br />Y <br />F <br />