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,:. - -- <br />°;SENDER: <br />'~ ' Complete hems tand/or 2 for atlditional sarv¢ea. <br />° • Complete items 3. and as & h. <br />~t • Prin[ your name and address nn the reverse of this form so [ha[ we can <br />i return this card to you. <br />• A[tach this form to the front of the mailpie<e, or on the back if space <br />tloe~ not permit. <br />• yJiite"fteturn Receipt Requested"on lhemailpiece below the article number <br />• Tha Return Receipt will show to whom the an¢le was delivered and the date <br />Addressed to: <br />~7'rr/~ / <br />~ 2 / ~i <br />Signature <br />~orm <br />/ ~ /r/~" <br />i <br />.= ~r ~ <br />~ad3 <br />1 also wish to receive [he <br />following services Itor an erctre <br />fee): <br />7. ddressee's Address <br />2. ^ Restricted Delivery <br />^ Registered Insured <br />erufied ^ COD <br />0 Express Mail ^ Return Receipt for <br />Mmrhandmw <br />3'9•~'s <br />8. Addressee's Address (Only it r <br />and lee is paid) <br />W.S. GPO: t W4-~J~ti~a¢ <br /> <br />3 <br />R / <br />