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<br />" SENDER: <br />m <br />$ Complete items 1 end/or 21or additional services. <br /> <br />1 a150 wish (O reCeivO the <br />~ Complete hems 3, and as d b. following services Itor an extra d <br />N • Print your name entl address on the reverse or this loan so m at we can feel: 'i <br />m return this certl to you. <br />> Attach tho farm to the front of the madpieca, or on the beck <br />does not permit. <br />it space <br />1. ^ Addre55CC'S Addre55 ~ <br />y <br />L Write"Return Receipt Requested"on the mailpece ba~ow the ar ticle number. 2. ^ Restricted Delivery n <br />• The Return Receipt will show to whom the snide was delivered <br />C delivered. entl the date <br />Consuls ostmaster for fee. d <br />° <br />v <br />y 3. Article Addressed to: 4a. Article Number ¢ <br />$ f <br />a ~,~ ThDn,~sor1 501 1 <br />~ ~~-~ ~ ~ r ~ 1 <br />n ~/ <br />~O Yf$P V4 1<r O VI I /15 ( 4b. Service Type <br />^ Registered ^ Insured ¢ <br /> <br />y P D ~~v, ^ r ~/ /_ <br />R / O lJ <br />kJ <br />I~Certified ^ COD <br />/ ~ <br />5 <br />w IT ^ Express Mail ^ Return Receipt for 3 <br />¢ ~ / Merchandise G <br />p <br />a ~O(i£(QY/(~ CO[D ~~3~ 7. Date of Dey er <br />~ 3 <br />~ <br />#' <br /> 17 <br />rt <br />1! o <br />Z <br />¢ <br />5. Signature (Addressee) <br />8. Addressee's Address IOnty If requested Y <br />~ <br />W - <br />- J <br />~ and fee is paid) ~ <br />L <br /> n <br />¢ 6. Signature IAgentl ~ <br /> <br />o <br />m PS Form 11, December 1991 C U.S.G.P.O. ~ 1992-30]-5~0 DOMESTIC RETURN RECEIPT <br />