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~iiiiiiiuii~iiui~i <br />999 <br />co <br />N <br />O <br />W <br />d <br />i. <br />Q~ <br />ll) <br />NC <br />C <br />ti <br />m <br />_•- ~ 179 166 285 <br />~~t~ied Mails-~(- ~'{~ <br />- o nsuranerCbrerege-Provided <br />~ru:<~; Do not use for International Mail <br />(See Reverse) <br />R <br />Y <br /> <br />Su ¢ei awn rro ~ <br />(,O_ <br />P O . Aaiy antl ZiP Cotle <br />r/ J <br />l J ~Q /~~Sgd <br />fi <br />e <br />V ~ <br />J <br />PosiaQe n ~~~ <br />9 <br />Cen~nec Fee ZZ <br />~. J <br />Speual Dam+eiv Fee <br />Pesincietl Dem•wy F¢e <br />Return Receioi Seewing <br /> <br />is Whom B Daie D¢ineietl //D <br />Rerun Pecemi 5 Whom <br />Oaie. an0 <br />TDTat _ ~ ~ ~ / <br />6 Fee <br />PO51 rk or Dal¢~ <br />~ o <br />9~ <br />0 <br />A <br /> <br />" SENDER: <br />• Complete items 1 antl/or 2 for additional services. I 8150 Wish [O reCQIVe thB <br />„ Complete items 3, and 4a 6 b. following services (for an extra ro <br />• Print your name end address on the reverse of this farm 6o that we can (eel: j <br />to return this card to you. m <br />m • Attach this form to the Irons of the meilpiece, or on the beck it space 1 . ^ Addressee's Address N <br />~ does not permit. <br />V • Write "Return Racaipt Retiuestetl" on the mailpiece below the article number. 6 <br />2. ^ Restricted Delivery •m <br />• The Return Receipt will show to whom the amcle was tlelivera0 antl the date <br />e delivered. Consult ostmaster Tor Fee. m <br />3. Article Addressed to: 4a, Article Number <br />m LOQ~,.y /~erG~lcr ~° l79 l(oCp ~~'~` <br />E POLUdG/-~6~~.n Coy ~ CO, 4b. Service Typ <br />~ / ~~ d ^ Registered <br />y PoQ ~/'ae.t' / ~ified <br />/ 4L ~.T4~e ~~ !~~`~,' 1~ ^ Express Meil <br />p 7. Date of Delivery <br />Q <br />z,: ~p 2y. <br />7 5.•Signature IAddresseel 9. Addressee's Address <br />F and fee is paid) <br />~ 6. Signature (Agent) <br />a°. l~r ~ <br />= PS Form 11, December 1991 a u.s.c.P.o.: ta92-aor-sso O(1MESTIf` RFT <br />^ Insured <br />^ COD <br />^ Return <br />I...n Ae <br />a <br />c <br />Receipt for ~ <br />ndise <br />7 <br />i if requested m <br />e <br />io <br />t <br />f <br />i <br />