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<br />SENDER: <br />~ • Complete items 1 end/or Z far etlditionel services. `-+ <br />• • Complete items 3, antl 4a 8 b. <br />~ • Print your name antl addreae on the reverse o1 this form so that we can <br />~ return this card to you. <br />i • Attach this larm to the front of the matlpiece. or on the back if space <br />~ does not permit. <br />• Wri[e "Return Recept Requested' on [he meilpieca below [he article number <br />• The Return Receipt will show to whom the article was deliveratl and the date <br />~ delivered. <br />a 3. Article Addressed to: 4a. An <br />0 11 ~~ l U 4b Sel <br />I also wish to receive the <br />following services Ifor an extra Y <br />feel: t <br />1. ^ Addressee's Address y <br />2. ^ Restricted Delivery •e <br />Consult postmaster for fee. m <br />:le Number <br />c <br />.~, <br />o qL n e ~~ ^+-~" / Q~v(tJr~, ^ Registered • <br />v <br />y CL.pfp.9..Q.h ^ Certified <br />w (o / '] ~ / O~[(Sa.u v e 7lOQ-R, ^ Express Mail <br />^ Insured <br />^ COD <br />^ Return I <br />Q QYA C~ 8 ~ YO ~ 7. Date of De~ ery <br />/ ~' . <br />5. S~ nature (Addressee) ~ 8. Addressee's Address lOr <br />H ~_ { ~ / Lc' and fee is paid) <br />s 6. Signatu a (AgentY ' <br />7 <br />PS Form 11, December t991 auS.GPO:tG0.N]sz-yte DOMESTIC RETUF <br />e <br />:eipt for ~ <br />se c <br />r p <br />T <br />requested ~a <br />m <br />L <br />F <br />