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r <br />SENDER: <br />o •Camplete items 1 anNOr 21or atlditiorW services. <br />I af50 Wleh t0 r0001V0 1110 <br />W •COmplete Items 3, da, and 4b. following SBNICBS (fOr an <br />m .Pant your name and adtlrees on the reverse of this form so that we wn return INS extra tea): <br /> card to you. <br />• Mach this Wrtil to the horn at the mellPiece, or rn the back if space tloas not <br />1. ~ AddfeS500'S AddfBSS ai <br />o <br /> <br />m Penna. <br />•Wale'Aefum Aeceipt Requested' on the mailpiece below the aside number. <br />2. ~ RBStriCted DBllvery m <br />N <br />~ •The Relum Receipt will show to whom Me aside was tlelivered antl Iha date a> f <br />~ ae~rvered. Consult posbnasterfor fee. .v <br />0 <br />0 <br />3. Article Addressetl to: <br />4a. ArticleFNumber ~7 (~ 7~ <br />m <br />,f .J._ <br />E <br /> <br />u° IA I ~,D~ ~ /'y~.( ~Jall~ <br />u "~O L(~ 4b. Service Type <br /> <br />^ Registered ^ Certified <br />u <br />~ <br />n 1 <br />Sq <br />O ~O`~ ^ Express a"Q ^ Insured <br />'l' ~ <br /> <br />N <br />~ - ^ ReN for Me ndi ^ COD ~ <br /> <br />] CU ~i ~~ `~ <br />Date [A li e <br />7 <br />~ <br />° <br /> . <br />ry <br />„ <br />;._ O <br /> ~•t-.. >, <br />~ 5. Received By: (Pri t Name) 8. Addra '60 Address ~1' requested t <br />ra ~ and le t <br />I- <br />~ fi. Sig re: (Add r ent <br />r <br />n x <br />Rs f=orm 3811, December f ssa ~ Domestic Return Receipt <br />