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SENDER: <br /> I also wish to receive the <br /> s • Complete hems 1 and/oh2�ar additional services. <br /> •.Complete Items 3, and Aa, t. following services (for an extra 0. <br /> w • Print your name and addl�s gn th�reve/se of.#his'form so that we can {eel: <br /> `e return this card to you • .r o <br /> IN • Attach this torn,to the front of the mailpiece,or on the back ihiyece 1. ❑ Addressee's Address y <br /> 2 does not permit. <br /> • • Write"Return Receipt Requested"on the mailpiece below thperticle number. <br /> 2. ❑ Restricted Delivery e <br /> • The Return Receipt will show to wham the article wes delivered and the date Y <br /> C delivered. - Consult postmaster for fee. tp p <br /> 0 3. Article Addresse to: t 4a. Article Number <br /> e <br /> $ #Gr. l,1Lc o s <br /> E t� / 4b. Service Type ¢ <br /> u >r}p-ryi 6 tom'Yl/.�QS'.t,+-n El Registered ❑ Insured <br /> rn n 2Of &Certified ❑ COD & <br /> m I' o 6ay ✓j O ❑ Express Mail ❑ Return Receipt for =0 <br /> ¢ Merchandise <br /> °o Colo Qa11A co laa3 7. Date of Delivery <br /> ¢ 5. re (Addre ee 8. Addressee's Address (Only if requested u <br /> r and fee is paid) m <br /> W L <br /> 6. Signature (Agent) <br /> 0 <br /> .4 PS Form 3811, December 1991 s u.S.G.P.o.:199DaWAaO DOMESTIC RETURN RE5-Wi <br /> 35 081 <br /> P ERTIFlEDED MAIL <br /> —f�� I N COVERAGE INTERNATIONAL MAILEG <br /> _ T FOR(SeeRe -rseMAIL <br /> �1_s (See Reverse) <br /> `s Sent to • <br /> _W <br /> m S,(reU n o. 3 3 g W <br /> d f Cn <br /> ru', p 0.State and ZIP C e I <br /> NCb( 1 <br /> o Postage 5 3 <br /> 7 <br /> CemLetl Fee <br /> Special Delivery Fee <br /> Restricted Delivery Fee <br /> Return Receipt showing ' <br /> to whom and Date Delivered <br /> a Return Receipt showing 10 4p <br /> Date.and Address of Delivery: <br /> m <br /> TOTAL Postage and Fees S <br /> 8 Postmark or Dale <br /> E <br /> V1 <br /> a <br />