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s <br />P 436 783 502 s ~~ '' <br />US Postal Service <br />Receipt for Certified Ma <br />No Insurance Coverage Provided. <br />Pasmge <br />Fea i / <br />Spedel Delivery F V `~' ' ' cR \ `~'~' <br />Rasldtlad Deti ry i ~ <br />~ Retum ReceiD c w~ </ Y~ <br />Whom 8 Date v v <br />'y Realm Receip m ^' <br />0 fn <br />Q Date,8lddressees Ch <br />O TDTAL Postage 8 Fces ~ D ~ <br />m <br />Posbnark or Date r <br />_= <br /> <br />lL G <br />a 0 <br />r <br />o SENDER: <br />n7 •Compete items t end/w 2Iw eddelorW aenricee. I also wish t0 reCeWe the <br />e .compete name 3, ea, and ob. follOwing seMces (for en <br /> • Pdm your name and etldraee on the reveres of thh <br />card to you brm w Net wa can Mum W e cadre fe6): <br /> . <br />•MmYt Nle bnn to dta hom of ttre mellpiea, w m the Wdr a spew does not <br />1. ^ Addressee's Address 8 <br />Z <br /> • Wnte'Refum Rewipr Requested' an the meilpiea Delow Ne adide number. ~r~ CIBd Dellve <br />ry <br />~ `~ - i <br />tR <br />~ •The Relum Receipt will show to whom Ne aditle wee degrered end the date <br />l Ti <br />C rverad. <br />de C.OnSUIt _ Br fOr fe6. <br />0 3 <br />ANd <br />Add <br />d t m <br />~ . <br />e <br />resse <br />o: 4e. A de r <br />~ ~ <br />~ s~ <br />a ~ <br />~~ SnooK _ <br /> ~ <br /> <br />( 4b. s M Type <br />a <br />~ C~~ ~ k h~ ^ Re ~e ~_ Certified ~ <br /> ~,,/ ~ <br />~ "/`~ s <br />' O r <br />~O ^ Expre ~ei~0810 ^ Insured <br />' n <br /> ~ ^ Retum Receip I <br />Alerdlertmae ^ COD <br /> ~~ ~~~ ~~/fS/ 1 <br />l l "~ • ~ <br />` 7. Date of Delive ~~ ~ <br /> T <br /> 5. Received By: (Print Name) S. Addressee's Address (Ontyflrequested ~ <br /> and /ee !s paid) t <br />~ <br />g 6. Signature (ddressee rAgen) <br />a <br />X <br /> PS Form 1, December 1994 102595-91.8-0119 Domestic Retum Receipt <br />