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m <br />~ SENDER: <br />•Complete items 1 and/or 2 for atltlilional services. <br />I a150 Wish t0 reCelVe the <br />"m <br />m •COmplete hems 3, Ia, and 4b. <br />• Pdnl your name antl atldress on the reverse oL:~9 Iprm su that wre can return INa <br />~ follOWing SBrvICB3 (fOr 8n <br />exffa fee <br />~ <br /> <br />i card to you. <br />•Atlach this form to the hoot of the mailpiece, or on the back if ° <br />space does oaf <br />7, ^ AddresSee's AddrBSS o <br />~ <br />Z <br />` <br />y permit. <br />• Wnte'Refum Receipt Requesled'on the mailpiece below the snick number. 2. ^ Restdaed D¢liVery y <br /> <br />~ •T11e Return Receipt will show to wtwm the snide was delivered end the date <br />delivered. <br />Consult postrnaster for fee. <br />o ~ <br />na <br />° 3. rficle Addressetl to: c mbar <br />~~ 19132 2 <br /> ~ <br />a <br />E <br />4b. Service Type ~ <br /> <br />v n ~w <br />r~O~n~v -1 <br />^ Registered ]CI Certified <br /> <br />~ <br /> <br />D <br />~ x ~~ ^ Express Mail ,a Insured c <br />n <br /> r • <br />r/ ^ Return Receipt for Merchandise ^ COD <br />o ~ry1 r~ ~ ~ ~ g'~ / 7. Date of Delivery <br />z <br /> 5. Received By: (Pdnf Name) 8. Addressee's A es / ~ esfed <br />~ <br />O ~ <br /> 0 <br />and (ee is psi <br />`~~ <br />~ 6. X tyr : (Ad rAgent O <br />~ J ~ ~ <br />a <br />A <br />PS orm 3811, December 1994 ~ <br />D R eceipt <br /> - L <br />- t -Pj 52 19 132 <br />t?u P servi 'j}ypQ p <br />eR sip r Certified Mail ~ <br />No Ins ce Coverage Provided. <br />use for In ational Mail See reverse <br />~\ =.. <br />W <br />J <br />N W <br />r ~b n.~e .~~,, .._ _ 7' <br />Postage ~ I S , <br />...,~..,~,., c• ~ <br />Spedal DelNary Fee <br />tV <br />Restdpetl Delivery Fea I I ~ <br /> <br /> <br />~ ........ ~amye ~aea n ' 1,.;. <br />Posimarq ar Data O <br />ti ~ CD <br />a ~ N <br />~,~- O <br />