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m SENDER: <br />TJ •Complele items 1 enNor 21or etldidonal seMCea. <br />I a150 Wleh t0 f0001Ve th0 <br />W •COmpfefe items 3, 48, entl 46. following SBIVICBS (f0f an <br />m •Pdm your name erq eddreee an the revena of this form so Ihet we ran relum tide Bxtfa fee): <br />card to you. <br />~ •Anach Nis form to the hom of the meilpiece, or on the back H space does not <br />t. ^ Addressees Address <br /> <br />2 <br />~ permit. <br />y •Wdte'Retum Rxeipr Requesred'on the mailpiece below the erode number. 2. ^ RBStrided DBIiVery y <br />$ •The Retum Receipt will 6how to wfrom the edtde was tlelivered entl the tlate <br />~ delivered. Consult postmaster for tae. <br />o m <br />3~rtlyle ddressed ty o^~ ~ W q~~JAr6(c'ley-Nyu bar C~ `~f '`~ c <br /> <br />o a a 55 `, ~~~ ~,,, ~ 4b. Service Type ~ <br />m <br />~ p ~ ~~ ~ ~ (~ ,,.~ Q7 ( <br />~ ~lw-a t tAdl.yG <br />LJE <br />J ZS I ~ ( ^ Registered Certified <br />°r <br /> ,.. <br />. ^ Express Mail ^ Insured E <br /> <br />^ Retum Reoeipt for Merdtandise ^ COD m <br />~ <br /> 7. Date of Delivery <br /> ~-~~/ S7 a <br /> <br /> 5. Rec iv d By: (Print Name) ^ 8. Addressee's Address (Only i/requested ~ <br />to - t , ~ l and lee is paid) r <br /> F <br />ti.5lgnature:fAacresseeorager <br />T X <br />A <br />PS Forth 3811, December 1994 <br />a <br />Q <br />N <br />OW <br />.: <br />N <br />C <br />N <br /> <br />~--~ <br />N <br />E <br />C <br />tT7 <br />~ a <br />f~ <br />C`') i <br />r <br />r C <br />r C <br />0 <br />I <br />® t <br />~ 076.556 78 <br />US Poslal Service ~~u_ J <br />R~c~i~O4 4oP f~ ~ <br />No Inwrance Cove 7 <br />Do not use for Intemauonel mai oee rer.roo <br />8 Number <br />ce, Spte, 6 LP Code 11O <br />Pmtape <br />Cerufied Fee <br />Spedal DeIMry Fee t.p`3 ~ ~. <br />Resbiged Delivery FTjb~ .~ <br />', Rewm fieceipt 9 tQ7 <br />Vltlan S Date Deli ~ D <br />F .' bwlxm, <br />Reesn Rsr4rpt <br />Deb.6Mdeseeek O ' <br />ff <br />~S <br />i TOTAL Pmtege 8 ~ <br />t <br />A <br />r Posenerk or Dale <br />i <br />7 <br /> <br />