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P 291 415 936 <br /> ' us Postal SWAM <br /> Receipt for Certified Mail <br /> No Insurance Coverage Provided <br /> Do not use for Inttonal Merl See reverse <br /> tema <br /> samw ;rylC 0/see. — fe s <br /> & <br /> PostSlate.a nP Code t 6,51 <br /> r <br /> Postage $ Z <br /> 1 rc <br /> wed Fee <br /> Special Delmy Fee <br /> Retied Dalmy Fee <br /> Retum Receipt Stowing toCD <br /> I t% <br /> V&,DM&Date Deivered <br /> ReOm Receipt 90*q to Whom, <br /> p$ Dates&Pdg A <br /> O <br /> TOTAL Postage&Fees $ ? <br /> Postmadc or Date <br /> a- <br /> i - SENDER: <br /> '0 •Complete items 1 and/or 2 for additional services. I also Wish to receive the <br /> m ■complete items 3,4a,and 4b. following services(for en <br /> I -.• •Print your name and address on the reverse of this form so rM we can return this <br /> o card to you extra fee): <br /> •Attach this form to the front of the mailplece,or an the bads if space does not Gii <br /> permlL1. ❑ Addressee's Address <br /> o ■Write'Retum Receipt Requested'on the maifpiece below the article number. N <br /> m <br /> •The Return Receipt will show to whom the article •re and <br /> d the date Z❑ Restricted Delivery <br /> o delivered. Consult Postmaster for fee. a <br /> I. v°.! 3.Article Addressed to: 4a.Article Number m <br /> fL ti Iql qr 9 3 v/ ¢ <br /> 1 0 Ric.l( 0/5e, -' ,A <br /> 6 4b.Service Type <br /> ( Ed (t Gvvu'Y S L( 6` J19 <br /> ❑ Registered 1(Certifted ¢ <br /> 1 36 GcJ• 3.eet s� Express� ❑ ress Mail ❑ Insured <br /> a <br /> o U,1 e Lv •❑ Retum Recelpt for Merchandise ❑ COD ' <br /> 1 t G -3,A 7.Date of Delivery <br /> ' o <br /> ! 5.Received By:(Print Name) 8.Addressee's Address(Only it requested <br /> and fee is paid) w <br /> c 6.Sign2ree, <br /> dress Agent)X i lsi{ ii41� ll i\ a i <br /> PS Form 5811, December 1994 <br />