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- -- - <br />SENDER: Complete items t end 2 when etlditional mrviess Ire dnired, and complete Items <br />our addren in the "RETURN TO" spacc on the reversq side. Failure to do this will prevem <br />from bin0 returned to you. Tha return receipt foe will Drovide You the name of the pefsor <br />toned To~rrQlM t~-M d_Niysry. rn Wd t ono • p scrv a~ awda-6fa. Coy <br />ra4rrasted. <br />2. ^ <br />$~-}' 1 ~ 3 <br />Sienoturw - AdArreewa <br />X <br />P 168 480 104 <br />RECEIPT FOR CERTIFIED MAIL <br />ND CISURANCE COVERAGE PROVIDED -~ ~i <br />NOT FOR INTERNATIONAL MAIL I <br />- I <br />3~.. See Reverse) ~ ~ i <br />J <br />~ Sent p <br />)slivery. ~ ~' <br />~(/-/~ ~ Str and NO.,„ I <br />~-~- P ,Slate and ZIP tle <br />a ~ ~ C ,,./ f ~7 ~// , <br />B Insu o Post e E <br />D ro <br />Always obtain slgnatura of addre~ <br />spent and DATE DELIVERED. <br />+t <br />' ` DO~TIC 11tTYRN <br />~~ <br />~ CeAilietl Fee <br />Special Dehrery Fee ~ <br />i <br />Restricted Delivery Fee <br />Return Receipt Showing <br />to whom and Date Delrvere0 _ <br />~ Return receipt~showmp to wh , <br />m Deta, antl r+tlor8~4s Df Delvery ..~ <br />o TOTgL Postage and FBPB ~ $ I <br />LL l <br />,' J <br />oc Po9 marR or Date ~ ~• ~ ~ <br />n <br />Ii <br />~I <br />m <br />a <br />