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~~~~~ <br />~~~ <br />~~ <br />CU7~;3 Ck71 <br />r` -~ <br />'" DMG•1313 <br />a <br />~ Postage <br />$ c <br />0- <br />0" CeKJietl Fee <br />rTt Return Receipt Fee / , <br />rR ~(Entlorsement Pequiretl) <br />~ Restricted Delivery Fee <br />~ <br />(Entlorsement Requiretl) <br />O ' <br />~ <br />~ <br />total Postage 6 Feas <br />O $ ~-t <br />. <br />S <br />rrl R~nYS Name Please Y t CI, <br /> ---_ <br />~ <br />U-' Street, Apt. No.; or Bdx No. <br />0 <br />f~ (~1y, State, lPw T .~ <br />Cf <br />~ (P t <br />a ! <br />~~ ~ <br />'f , <br />d 15 (JfIJ <br />^ Complete items 1, 2, and 3. Also complete <br />item 4 if Restdcted Delivery is desired. <br />^ Print your name and address on the reverse <br />so that we can return the card to you. <br />^ Attach this card to the back of the mailpiece, <br />or on the front if space permits. <br />1. Article Adtlressetl to: <br />T-~ ~-~ <br />~nr~c -~ <br />a~c~g ~c,rnp~s<s~~ yya-~- <br />//~~ ~~ ~~~ ~~ T p JLLILC ~~~ <br />~5c~11v1~ ~JUatG'r1bV11 ~CU _ <br />A. Received by (P/ a Print Clearly) B. Date f Dapl' ery <br />J ~ . ~S~/~~ f~2J~3 <br />C. Signature <br />X G!' ^ Agent <br />^ Adtlressee <br />D. ~IS delivery address different from item 1? ^ Yes <br />If YES, enter delivery atldress below: ^ No <br />3. Service Type ' <br />^ Certified Mail ^ Express Mail <br />^ Registered ^ Return Receipt for Memhantlise <br />^ Insured Mail ^ C.O.D. <br />4. Restricted Delivery? (Extra Fee) ^ yes <br />2. Article Number (Copy /rom service laben <br />'1~~3~ oo ~ l 3 9~IV l 5'71 ~ <br />PS Form 3811, July 1999 Domestic Remm Receipt 102595-9g-M-0952 <br />