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•SEN DE R: Complete Items 1 end 2 when etlditlonel services are desired, end complete Items 3 <br />end 4. <br />Put your etldreas In the "RETURN TO" Space on the reverse slde. Fellure to do this wlll prevent this <br />certl from being returned to you. The return rxalot fee will provitle you the name of the oanon <br />deliveratl to end the tlete of tleliverv. For edtlltlonel fees the following services ere available. Consult <br />postmaster for tees entl check box(es) for etldlilonel servicelsl requestetl. <br />1. ^ Show to whom dellvpretl, dote, entl atltlreuee's edtlrasz. 2. ^ Restrlctetl Delivery <br />t (Extra charge) t t (Extra charge/ 1 <br />3. Article Addressed to: 4. Article Number <br />J'~g-~ T~wt~ <br />c Dt,t ~ s l a~ ti s 9 <br />. <br />~~ ~~ ~~ ,~.JJ <br />i~~Q ~Ort~t °E" <br />om' <br />~ Type of Sarvica: <br />^ Registered ^ Insured <br />n~ <br />"" <br />EQy NU,Q <br />I lJa N CtLQ C.t Certified ^ COD <br />- ^ Express Mail <br />~.~. / ~ ~O/~03 Always obtain signature of addreuee <br /> or agent and DATE DELIVERED. <br />5. Signature -Addressee 8. Addressee's Address /ONLY if <br />X ~ requested and fee paid) <br />6. i atur -Age t ` <br />7. Date of Delivery <br />~, ~/ Z `/ <br />PS Form 3811, Mar. 1987 ~ <br /> <br />a <br />m <br />LL <br />0 <br />LL <br />N <br />a <br />~ w U.S.G.P.O. t997-17&aae DOMESTIC RETURN RECEIPT <br />P 051 874 596 <br />RECEIPT FOR CERTIFIED MAIL <br />NO INSURANCE COVERAGE PROVIDED <br />NOT FOR INTERNATIONAL MAIL <br />P ~ (See Reverse) o a • ..7.,~~ r- <br />Sent to ~ S <br />1 <br />Street antl No. ~ <br /> <br />P.O., Stale and ZIP Cotle ~ <br />c ,y; <br />6 v7 w <br />Postage = C/J <br /> S <br />:J <br />Cen r _ p~ I4/ a ~ _„] <br /> <br />Special Delivery Fee ~ ~~ <br /> I ~ <br />Restricted Delivery Fee a <br /> N <br />Roe}yUyfT car gv{ln f Ca.s <br /> <br />Relur <br />g~ <br />~ ~ <br />Dat , an tltlress <br />llvery v <br />T A Pos[a s <br />L <br />Po k ~ e j <br />1TAO O ~ O? <br />r <br /> I . J <br />