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<br />o p 436 785 332 ~6 <br /> ~ <br />7~ <br />O <br />°O US Postal Service <br />Receipt forCertified Mail ~ <br />0 No Insurance Coverage Provided. <br />(~ Do not use for Inte adonal Mail See rev <br />` <br />d Sent l V ~ , \ 1 <br />y <br />~ Street 8 Num <br />30 6 00 <br />O P t Olfice, State, 8 ZIP ~~ _ 3 <br />~ r <br />N Pasla9e $ <br /> CerGtied Fee GE D VF' <br />f~ _ .. <br />Restricted <br />Retum Re <br />Fees ~ $ <br />m SENDER: <br />:~ .Complete items 1 antl/or 2 Ior additional semces <br />in <br />a I also wish to receive the <br />10110Win eeNlCee (ter an <br />9 <br />L • Complete items 3, da, antl <br />b. <br />• Print your name antl adtlre55 on the reverse of this lone so That we can return this a%tfa fee): <br />d <br />m card to yyou. <br />• Adach th s lone 10 the Iron) of the madp~ece, or on the back it Space does not 1. ^ Addressee's Atldress G <br /> <br />~ perms. <br />• Wnte 'Return Receipt nequesfetl'on me mailplece pelow the edicle number. 2. ^ Restricted DBlive <br />rY w ' <br />N <br />.t. ~ dalrveredm Receipt will show to whom the article was delivered an d the date Consult postmaster for fee. g . <br />o` 3. Adicle Addressed to: 4a. Articl Numper ~~ _ v <br />m <br />a <br />u / <br />3O 8 ~1p ~ 4 . Service Type <br />^ Re <br />istered '~- l~.Certified ~ ~. <br />~ <br /> _ n _ n( <br />~r r`~j 663~-9j7 g <br />^ Express Mail ^ Insured <br />^ Return Receipt for Merchandise ^ COD p <br />~ <br />~ <br /> 7. Date~tQeliverv <br />1 r <br />~'` <br /> - <br />r~rlc ~ <br />o <br /> 5. Received ey: (Print Namel 8. Addressee's Address (Only it requested r <br /> ~~„ ~ ~ and lee is paid) m <br /> 6. Sign' ddressee or Agent) <br />'o <br />a X <br />Rs Form 3811.; o~rcbq~r f ssn 102595 ~&B-0229 Domestic Return Receipt <br />