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SENDER: I also wish to receive the <br /> � • Complete items 1 end/or 4 for additional aarviva. <br /> • Complete items 3,and 4e a b. "' following services (for an extra <br /> • Print your name and address on the reverse of this form so that we can feel: <br /> realm this card to you. <br /> e Attach this form to thefrom of the mailpiece,or on the beck if space 1. ❑ Addressees Address <br /> e0M not permit. <br /> • The Return <br /> Receipt lRequested- <br /> show t won the ample was d li the <br /> ered an a he data. 2 ❑ Restricted Delivery <br /> • The ReNrn Receipt will show to whom the article was tlNivsretl and the date <br /> rfaxyeroa. Consult postmaster for fee. <br /> 3. Article Addressed to: 4a. Article Number <br /> ChviS ► rr-L.VarKx z g 7 a <br /> C V0Lyr0t leV Ma-K+nCd 4b. Service Type <br /> ❑l egistered ❑ Insured Q� <br /> S•`IW 7'- <br /> �� L2ertified ❑ CODLU <br /> ❑ Express MeilReturn Receipt forC Merchandise <br /> 7. Date of De v y <br /> C 5. Sig ure (Addresse 8. Addressee's Address (Only ifYeqd6sted l <br /> and fee is paid) <br /> F <br /> 6. Signature (Agent) <br /> PS Form 3811, December 1991 au.a rro.to-sse-7'14 •DC LWSTM RETUM WCE1PT <br /> 4L6 876 539 <br /> off= C.�ftifie�� hTaIF �- <br /> iVp InsuranceR ra�j] t <br /> Do not use for inter <br /> ha - 93 <br /> (See Reverse]] swo <br /> m <br /> m <br /> t qlP+`A <br /> ro <br /> t d, gcc)DD <br /> rn <br /> 11 D,-, , <br /> OTi[ <br /> Dw <br /> :n0 Arc <br /> 00,- prj�L�i. r <br /> r0.4i for.i53` v`, <br /> d F—, <br /> I <br /> S posl^�erk o` ba•y <br /> S <br /> I� <br />