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4 3 6 7 8Spa?1 '!O%& <br /> P <br /> US Postal Service ��_ <br /> Receipt for Ce <br /> No Insurance Coverage Provided. <br /> Do not use for Intern <br /> Tonal Mail See reverse <br /> Street&Numb r c��s <br /> P office,St te,&ZIP e <br /> Postage $ ' <br /> Certified Fee D <br /> Special Delivery Fee t. 99, <br /> Restricted Delive <br /> rnReturn Receipt tt g tom S <br /> Who &Date D I�0 d <br /> a Return Receipt Sho <br /> Q Date,&Addressee's <br /> �O TOTAL Postage&Fee <br /> 00 <br /> ce) postmark or Date <br /> E <br /> 0 <br /> LL <br /> 0 SENDER: 1 also wish to receive the <br /> 'o ■Complete items 1 and/or 2 for additional services. <br /> m ■Complete items 3,4a,and 4b. following services(for an <br /> m ■Print your name and address on the reverse of this form so that we can return this extra fee): <br /> card to you. <br /> ■Attach this form to the front of the mailpiece,or on the back if space does not 1. ❑ Addressee's Address Z <br /> permit. <br /> m ■Write-Return Receipt Requested'on the mailpiece below the article number. 2. ❑ Restricted Delivery N <br /> ■The Return Receipt will show to whom the article was delivered and the date a <br /> delivered. Consult postmaster for fee. a <br /> ° 4a.Article Number <br /> � 3.Article Addressed to: <br /> a 0 )0 '7gq aq E <br /> L ervice Type <br /> E /� <br /> _A— ❑ Registered <br /> A7/ 7 ,,,„y�_ �� °p�/� ❑ 5-xpress Mail ❑ Insured <br /> �" __� w <br /> ❑ Return Receipt for Merchandise [I COD $ <br /> 7.Date of Delivery <br /> z <br /> 5.Received By: (Print Name) 8.Addressee's Address(Only if requested c <br /> w and fee is paid) t <br /> F- <br /> g 6.Sign re:(Ad ss e eorAgent) <br /> T X <br /> m <br /> PS FoW W311, December 1994 102595-97-B-0179 Domestic Return Receipt <br />