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SENDER: <br /> Complete items 1 and/or 2_for,additional services. <br /> -Complete item3'3 and¢a�h�_,a I also wish to receive the <br /> • Print your name and address on the reverse of this form s -2ha following services (for an extra V <br /> return this card to you. e�ca_ <br /> > • 2 Attach this form to the front of the mailpiece,or on the back if ace t 1 ❑ Add A-& <br /> � does not permit. p 1• ► SS Address m <br /> =_ • Write"Return Receipt Requested"on the mailpiece below the article number. <br /> c • The Return Receipt will show to whom the article was delivered and the date y <br /> delivered. 2. El Restricted Deliver <br /> Article Addressed to: <br /> Consult postmaster for fee. <br /> � I � <br /> ., s C <br /> 4a. icle Number GC <br /> a <br /> LA <br /> 0 7514(4) /35 <br /> 4b. Service Type <br /> y �•©, x ❑ Registered ❑ Insured <br /> �ertified ❑ COD <br /> W (� C <br /> p [Qr.C'�10-0 1 �4Z3 ❑ Express Mail ❑ Return Receipt for <br /> G Merchandise <br /> Q 7. Date of DeiiverX o <br /> ZCC 0 <br /> 5. Si re ddress e► - � o <br /> 8. Addres ee's Address (Only if requested,- <br /> LU and fee is paid) <br /> W C <br /> s• Ignature g t) W <br /> . � t <br /> o F <br /> �+ PS Form 3811, December 1991 U.8.G.P.O.:1992-307-530 DOMESTIC RETURN RECEIPT <br /> a <br />