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i• • <br />SENDER: I also wish to receive the <br />• Complete items 1 and/or 21or addiLOnal services. <br />' (olowin services (tor an <br />9 <br />. Complete hems 3. aa, and 4b. <br />. Pnni yom name antl atltlress on the reverse of phis brm so Iha~ we can rewrn this extra lee): <br />' card to you <br />• Attach This Iprm to the Uonl of the matlpiece, Or on the back A space OoeS npl <br />1. ^ Addressee's Address w <br />~ <br />.Wn el''ReNrn Receipt Requestetl'on the maipiece below the ad¢ie number. 2. ^ RBStriCled Delivery rn <br />. The Return Receipt will snow to whom the article was delivered antl the tlate (;nnsult nnsimasiwr tnr laa .. <br />;1. AniCle Atltlreaeetl tb: 4a. AfliCle Number u <br />-- Z 433 440 d25 <br />~o5t' ota°roCou mil <br />Corxerv~lon pi ICt~~I'.1~ 4b. Service Type ~ <br />~y~ C ^ Registered ~Cedified <br />Z~~ ~vK1 ~ ~~ .7 ~6~ ^ Express Mail ^ Insured ~ <br />~O~i'.~I~'ort~! ~q-r,~0 HIN 7 ^ RetumReceiptforMerchandise ^ COD ~ <br />~~O 7. Date of Delivery o <br />-~• 9y <br />5. Received By: (Print Name) B. Addressee's Address (Only i! requested <br />and lee is paidl <br />or AgynQ / <br />// /_'~-x <br />PS Form 3811, December 1994 102595~9a 90229 Domestic Return <br />