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J~~~6 942 272 ~. <br />0 <br />0 <br />E <br />e <br />d <br />m <br />/_ <br />O <br />LL <br />7S <br />Ce~~iflet'F-=""'~ <br />~I~ No Insurance Coverage Provider <br />:Llryu°v. D6~o~s~e4for t ~ne[ional Meier <br />~ ~ <br />s.„~gn Oj~ <br />Q+f <br />P s ream' ^~ <br />Postage <br />Cen~Letl Fee ~ <br />r <br /> (V <br />Speoai Deeverv Fee <br /> C- <br />Re;une0 Deiwery Fee <br /> C <br />Rerun Receip~ Snowing CO <br />m Wnom 6 Dare Delwmed <br />Reims Rece~p~ Snowing io Wnom. ~" <br />Oaie. antl AtlE~essee's q~0r ~ <br />TOigl Postage ~ \S• <br />F <br />' <br />J <br />• '~ <br />ees ~ <br />J <br /> <br />Posmark of Datey <br />r T <br />~rj <br /> <br />" <br />" <br />f <br />~ <br />~ <br />~ ~~ <br />~ 'F7{~e: <br />~~ <br />_ ~ <br /> <br />$ SENDER: I also wish to receive the <br />. (:omplele items 1 endor 2 for atlditlonel eervlcea. <br />W a~omplete items 3, 4a, end tb. 1011owing sefVlCBS (for &t <br />•Pdm your name end address on Na reverse of this krtn sd that we cea velum Ihie BXira 1BB~: <br />.. card to you. <br />.Mach this form to the ham of the meilpiers, or on the beck it epem does nm ~, ^ AddrBSSae'S Address <br />o permit. <br />y aWnfe'Retum Receipt Requested'on the mailpiece below the aside numbac 2. ~ RBStdcted DBIIVBrtI <br />$ .The Relum Receipt will show to whom the Mide wee deliveretl antl the dale <br />~ delivered. Consult postmaster for fee. <br />3. Ardcle~ressed to: 4a. Art~'Glg Number ~ ~~ <br />m ~ ~~ '(/ <br />° 4b. Service T e <br />°u _y/Q~Q~ ~/(lf S ~ ^ Re isteredP Certified <br />/ D q~ OIL l ,/ ,~~. ressM I ^ Insured <br />Y ,U/1 O 7 / p 7 ~ A um Re Ptlp erchandise ^ COD <br />~ /r n .a ... , /1 rJ; ,J /f„ 6 ~t-/ ^!~~ ate of <br />(J~,C/((fly (,,((,LI (~(J J o;~~' f' <br />~ 6. signatu 9' (AtldreSSee or <br />a X <br />i <br />n <br />ti <br />u <br />Z <br />d <br />Y <br />e <br />.~ <br />o` <br />0 <br />a <br />e <br />a <br />z <br />r <br />PS Formt3811. DAa6mber <br />