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•Complele items 1 ardor 2 for additional servirss. <br />•Complete items 3, 4a, and 40. ~ :. <br />• Print your name entl address an the reverse of thiSfonn 9o that we can return this <br />card to ycu. <br />•Attech This loan to the honl of the mailpiece, or on the back if space does rat <br />pemid. <br />• Wdte'gelum geceipr gequesretl'on the mailpiars below the anicle number. <br />•The Return Receipt will show la whom the adide was delivered and the date <br />delivered. <br />3. Article Atldressed to: <br />MR RANDY SCHAFER <br />PHILLIPS COUNTY <br />221 S INTERDCEAN <br />HOLYOKE CO 80734r <br />ivory <br />^--~ o <br />r <br />sAddress (Only i/requested ~ <br />PS Fortn 3tl71, 0eceptber 1994 <br />~G• <br />~~ <br />v <br />0 <br />0 <br />c <br />a <br />C <br />G <br />0 <br />3 <br />u <br />c <br />~P~]}3,351 N52 <br />~ <br />v ~ <br />r~B <br />U <br />ec tfor ~ <br />I ranee rovid <br />~: r <br /> <br />sm,tt MR RaNAY .Scxa~~t <br />Street PHILLIPS CO[jl7TY <br />221 •S 11VTERDCEAN <br />PastO HOLYORE CO' 80734 <br />Posmge S <br />Certified Fee <br />Spedal Delivery Fee <br />Restricted Delivery Fee ~ <br />Return Receipt Stowing to <br />Whom 8 Dale Delivered ~ <br />Rehm Rene 5hun9mYAUn, C <br />D <br />DaR, 6 Adrtresee's M6es+ A <br />TDTAL Paslage 8 Fees $ C <br />' Posbnark or Date ~ <br /> c <br /> ti <br /> c <br /> v: <br />I also wish to receive the <br />following services (tor an <br />extra fee): <br /> <br />1. ^ Addressee's Address u' <br />~ <br />2. ^ Restricted Delivery y <br />Consult postrnaster for fee. <br />. <br /> ~ <br />tuber m <br />~~35i85a <br />rpe ~ . <br />Y <br />^ Registered Certified <br />m <br />^ Express Mail ^ Insured c <br />^ Return Receipt for Merchandise ^ COD ~ <br />and !ee is paid) <br />r <br />F <br />i <br />