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a -SENDER: <br /> <br />V <br />•COmplae itemsl and'ar2lar additional twrvicet. I also wish to receive me <br />w •Comgete items 3, 19, aM Ib. }olowing SefVICBS (}Or en <br />m •Pdnt your name eM address on the ravens of this brm so that we can return this extra fee <br />~ <br /> <br />j card to You. <br />•Anach this loan to the horn wf the mailpiece, or on the Dark it cpace does not <br />1. ^ Addressee's Address ai <br /> <br />.2 <br />m permit. <br />•Wdte'Refum Heceiq Reques(ed'on the meilpieoe below the enicle number. 2.^RBSidded DBlivery ryj <br /> •The R,aum Recetq vall show to wtam the adida was delivered end the date <br /> <br />~ <br />delivered. <br />Consult posbnaster for fee. n <br />. <br /> <br />0 ~ <br />v Article Addressed to: ~jArticle/~N~u` ~bar C' $ <br /> <br />E 4b. Service Type <br />°u l~L ~~Q~ ^ Registered ~CeRified <br />to `~ IVl rn <br />^7 ~,, ry ~ ~ ^ Express Mail nsured 5 <br />¢ 1 ~ L- t r UI~V L ~ ~ ^ Return R ipt for Merchandise ^ COD W <br />°c 7. Date lv ry ° <br />`~1.a'Y10.~~ X10 - ~ . ~-ZZ~--~ <br />5. Received By: (Print Name) 6. Addressee's Address Onl i! requested ~ <br />~ ~ and tee is paid) i <br />~ 6. Signature: (A r t) (~ _~Q. <br />i. X <br />n <br />PS Form 3811, December 1994 Domestic Return Receipt <br />~ z 191 s ~t$e~k~ <br />bus Postal service File # <br />1 Receipt for Certified Mail--- <br />(,a No Insurance Coverage Provided. <br />-_` Do not ucw fnr Infwmwtinnwl Mail /Caa A..e2ei <br /> 1 <br />~ t <br />m <br />' S}igc16 Number <br />- <br />. 1U P str <br />~, oe.5tate./<ZIPCod <br /> <br />nor <br />~ a <br />_ Postage. s <br />~ . ~_ <br />. <br /> .~ <br /> Delivery <br /> _ ed DeGv~ry Fee fA <br /> R wvig to- 47 O <br /> • i d D erverad <br />~ ~9 <br /> 8 's Adtt¢s <br /> OTAL Postage 8 Fees ,b' <br /> osbnarx or Date <br />rn <br />a <br />