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' $ SENDER: <br />_ .Complete items 1 snNOr 2 for etldtlorul servk;ee. <br />' • .Complete items 3, u, end fib. <br />• PtlM your name antl atltlrem on me reverse al thb brm co met we fan velum Nla <br />1 ~b~~,. <br />• Adach is loan ro the front of the mellplece, or on me beck If apace does not <br />pee. <br />• Write 'Rehm gece/pr Requested' on the mellplece below the stride number. <br />• Tne Relum Receipt will show to whom Na article was deliveretl entl Na tlale <br />delivered. <br />0 3. AAicle Addressed to: <br />~ Y~cn. <br />~ ~~~~~ <br />` 535 <br />~O.r <br />n~,tQe~, ~' p g 14 34- <br />5. Received By: (Print Name) <br />6. Sig t re: (Add sse <br />X <br />9 PS Form 3811, Drscemb 1 94 <br />I also wish to receive thB <br />following services (for an , <br />extra fBB): tg <br />1. ^ Addressee's Address ~ <br />2. ^ Restricted Delivery <br />ConsWt postmacter for fee- S <br />....v r u~ r .. c.~...a_~ uvu r -re~u,~ E <br />4b. Service Type ~ <br />^ Registered ertified <br />^ Express Mail ^ Insured ~ <br />^ Ratum Receipt for Merchandise ^ COD ~ <br />7. Date of Delivery ?i <br /> <br />8. Addressee's Address (Only it requested <br />end lee is paid) S <br /> <br />1g259S9B~e-0428 <br />fL <br />r" OMG•1313 Sherman, Rm. 215, Denier, CO 80203 <br />s <br />O~ Postage $ ~ <br />-~ Candied Fea <br />0 <br />Return Receipt Fee <br />O (Entlorsement Required) <br />0 <br />p Restnded Delivery Fea <br />~ (Entlorsement Regmretl) <br />O Tptal PoctaBa b Feec <br />r` <br />.~ R Ipienfc Ne a (Please Pnnr C~ <br />~ -~(_~5-- ~ i.-- <br />5 Apt. NO' P Box NO. <br />-~- 53~ <br />p City rata, ZIP+a ~ ~~ <br />r <br />"? -: <br />~71 <br />1, <br />'~~~ C <br />\ ~~ <br />81~+34- <br />