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` SENDER:o .Complete items 1 and/or 2 for additional services. I also wish to receive the <br /> n .Complete items 3,4a,and 4b. following services(for an <br /> e •Print your name and address on the reverse of this form so that we can return this extra fee): <br /> card to you. <br /> a -Attach'this form to the from of the mailpiece,or on the bad if space does not t, ❑ Addressee's Address Z <br /> perm <br /> a •Wme'Retum Receipt Requested'on the mailpiece below the article number. 2. 0 Restricted Delivery pj <br /> C •The Return Receipt will show to whom the article was delivered and the date <br /> o` delivered. Consult postmaster for fee. L <br /> 'm <br /> a 3.Article Addressed to: 4a.Article Number d <br /> .g _ Z 191 597 475 cc <br /> n Mr Gary D Snook <br /> E 4b.Service Type <br /> Adience Inc dba BMI France m <br /> °u ❑ Registered �Certified cc <br /> 2; Noblestovm Rd at <br /> JU Carnegie PA 15106 <br /> ❑ Express Mail ❑ Insured <br /> s ❑ Return Receipt for Merchandise ❑ COD <br /> t 7.Date of.pel' ery 0 <br /> 5.Received By: (Print Name) 8.Addressee's Address(Only if requested <br /> and fee is paid) m <br /> t <br /> g 6.Sign ure (Addressee or ) <br /> o X <br /> n <br /> PS Forrn 811 Dece r f Domestic Return Receipt <br /> Z 191SJ <br /> Sy <br /> C. US Postal Service c <br /> a 1`3 <br /> Receipt for IS 'fled Mai -7,73, <br /> W No Insurance Coverage Provido3.--- 1---- <br /> W Do not use for Intcmadonat Mail See reverse <br /> °Ito <br /> Cary D Snook <br /> c <br /> 27 Nobles <br /> Poat Olgce, C 8 to <br /> Pasteg° y <br /> Cerdfied F <br /> e-- sPedel Dews 66 q20 <br /> ui ReshiClod Delivery Fee <br /> Whom a oa pa Show <br /> to (Z <br /> Data RA1pAtlbeysyAan <br /> TOTAL Portage 8 Fees $ <br /> asroft or Data <br /> N <br /> a <br />