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d SENDER: <br />• ■ Complete items 1 and/or 2 for additional services. <br />in •Complete items 3, 4a, and 4b. <br />a) • Print your name and address on the reverse of this form so that we can retum this a <br />- bm card to you. <br />m • •Attach this form to the front of the mailpiece, or on the back if space does not <br />• permit. <br />w ■ Write'Retum Receipt Requested' on the mailpiece below the article number. <br />r •The Retum Receipt will show to whom the article was delivered and the date <br />c delivered. <br />-°i 3. Article Addressed to: <br />a <br />CO <br />W <br />a <br />CC <br />5. Receive B (Print Na e) <br />cc <br />PACM tool <br />%2)5 E Ic..Lw.x C . <br />t= bt,�1■15 C� qt)5 ?y <br />/ 2 A i < A. {-e <br />6. Signature: (Addressee or Agent) <br />X <br />PS Form 3811, December 1994 <br />I also wish to receive the <br />following services (for an <br />extra fee): <br />1. ❑ Addressee's Address <br />2. ❑ Restricted Delivery <br />Consult postmaster for fee. <br />7008 3230 0002 7252 9507 <br />4b. Service Type <br />❑ Registered 0 Certified <br />❑ Express Mail ❑ Insured <br />❑ Retum Receipt for Merchandise ❑ COD <br />7. Date of Delivery <br />8. Addressee's Address (Only if requested <br />and fee is paid) <br />Domestic Return Receipt <br />>p- zo //- 022 <br />• <br />7Zo-- <br />&Ai v'keta <br />f r • /4 -0-uti A <br />MA-c- <br />+v 1RMS <br />d <br />rn <br />c <br />0 <br />