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• Complete items 1 and/or 2 Tor additional services. ~ I also wish to receive the <br />• ~~mptete items 3, and 4a & b. following services Itor an extra <br />• t your name and address on the reverse of this form so feel: <br />th~-/e can return this card to you. <br />• Attach this form to the front of the mailpiece, or on the ~ ~ ^ Addressee's Address <br />back if space does not permit. <br />• Write "Return Receipt Requested" on the mailpiece next to 2. ^ Restricted Delivery <br />to: <br />-- - -- r <br />MONTANA DEPT OF STATE LANDS 4b. Service Type <br />1625 11TH AVE ~^,./~ Registerety ^ Insured <br />CAPITOL STATION tatfCertified~„ ^ COD <br />11$LENA MT 59620 ^ Express Mail ^ Mercrhand seipt for <br />"•' ~ -~~ ~ Date of Delivery <br />tc:itlV <br />APR 0 5 1QC~ 8' Addressee's Atl <br />and fee is paid) <br />'ATE <br />Pct m 1, ctober t 990 ~~.s. cro +ooo-xrseat DOMESTIC RETURN RECEIPT <br /> <br />