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�Iii Illliilllilil <br /> 999 <br /> M1 <br /> a SENDER: <br /> q • Complete items 1 andIor 2 for additional service%. 1 also Wish to receive the <br /> i • Complete items 3,and 4a a to. following services (for an extra o <br /> • Print yocl name and address on the reverse of this form so that we can fee): •� <br /> O 7hturn this card to you. <br /> e • Attach this?arm to the front of the mailpiece,or an the back if space 1. ❑ Addressee's Address y <br /> does Trot permit. <br /> • Wilt."Return Receipt Requested"on the mailpiece below the article number. 2 El Restricted Delivery g <br /> • The Return Receipt will show to whom the article was delivered and the date •O <br /> o delivered. Consult postmaster for fee. <br /> v 3. Article Addressed to: Article Number C <br /> Qavl {t, I I XG (DO-1 Le 10 <br /> E -RD�L` a y^r fba 60 • 4b. Service Type a e <br /> p ff , ❑ Registered ❑ Insured <br /> y 131 JD 7 r' ) �t �eV)Ce Certified El COD <br /> to Q�( 3 i��' ❑ Express Mail ❑ Return Receipt for <br /> Merchandise <br /> 7 <br /> . Date of ery <br /> Q 00 <br /> R5, Signatur Addressee? B. Addressee's Address(Only if requested Y <br /> and fee is paid) <br /> P.Uj <br /> Q nature f• <br /> PS Form 11. December w.s.opo: -.,I DOM STIC RETURN RECEIPT <br /> P 296 607 610 <br /> Receipt for <br /> Certified M <br /> No Insurance Co ra 7 ov ed <br /> r«r..,...at Do not use tDr,l to n all <br /> (See Rev tir <br /> l` 71 <br /> U Sueei antl rro � 1h� <br /> l <br /> U o. ie a�o'R /,` <br /> � Q. �IA t C-lrEe r <br /> 6 Postage $ <br /> .V Cemfien Fee <br /> Soec,a!Dew y <br /> Resrncied D ^.V <br /> •� Rewm Recem!S a <br /> 9T om&Dais, eiry rcrh rC a7. <br /> �d Rewm R@ <br /> CYyC� Oaie,antl Atle�ess "s I -�T <br /> TOTAL Posia9e ✓j! a %' <br /> B Fees <br /> Postmark OF Dale <br /> N <br /> a <br />