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<br />~' <br />^ Complete items 1, 2, and 3. Atso complete <br />item 4 if Restricted Delivery is desired. <br />! ^ Print your name and address on the reverse <br />! so that we can return the card to you. <br />1 ^ Attach this card to the back of the mailpiece, <br />or on the front if space permits. <br />.1. Article Addressed to: <br />~21,~i o uS ~,.~.~~ 4~ <br />A. Received by (Please P 'nr Clearty) B. Date of Delivery <br />~x:4 ~ v- 1.0- <br />C. Signatu e <br />X f ^ Ageht.~: ; <br />^ Addressee' <br />D. tlelivery dre ent from item t? ^ Yes„ , ' <br />'. If YES, enter tlelivery atldress below: ^ No ^ ' <br />II <br />C`- 3. Service Type <br />~~,,w,,~5 (7[~ ~J1.aL~~11~~ -~,Gertifietl Mail ^ Express Mail <br />~/~~~/// "`""`"""" ~J~ ~.Aegisteretl ^ Return Receipt for Merchandise <br />~p ^ ^ Insured Mail ^ C.O.D. <br />!JJ I <br />4. Restricted Delivery? (Exr2 Fee) ^ Ves <br />t 2. Artie <br />I PS Fo <br />~ ~ . .r <br />fL .t <br />S C~~ rU <br />ra 1t" <br />~ Posta9e <br /> <br />~ Certified Fee <br />m Retum Receipt Fee <br /> (Endorsement RequireC) <br />O <br />p Restricted Delivery Fee <br />p (Enporsement gequireC) <br />0 Total Postage & Fees <br />R1 <br /> <br />rn g <br />Na._~tnC.vt~~~ <br />Q• Street, Apt. <br />; or PO <br />N <br />o <br /> ^ <br />' <br />, <br />~ Ciry!Sr <br />Z/Pi 4 ` <br /> ~ <br />~ /)!r .n <br />'' ~ - - - _. -o,: .ice. <br />1 ~. <br />#595-99-M-1 ie5 <br />