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• <br /> ci SENDER: I also wish to receive the <br /> a ■Complete items 1 and/or 2 for additional services. following services(for an <br /> rn ■Complete items 3,4a,and 4b. <br /> H ■Print your name and address on the reverse of this form so that we can return this extra fee): <br /> card to you. �_ <br /> at ■Attach this form to the front of the mailpiece,or on the back if space does not 1.El Addressee's Address v <br /> permit. <br /> ■Write"Return Receipt Requested"on the mailpiece below the article number. 2•❑ Restricted Delivery N <br /> d ■The Return Receipt will show to whom the article was delivered and the date <br /> r Consult postmaster for fee. fl <br /> delivered. <br /> 0 3.Article Addressed to- 4a.Article Number . <br /> E. <br /> n pz, � 4b.Service Type <br /> ❑ Registered Certified o <br /> U o �try <br /> (n P ',,,,f�,, ,l / 1 ❑ Expres ❑ Insured <br /> w /��� L w v6, ��/ eturn Receipt for Merchandise COD , <br /> L <br /> C 7.Datliv <br /> a 'o <br /> ¢ 5. eceived By Print Name)_ n L 8. Add ss(Only if reques d Y <br /> )0,0,-)G/�dd� and f is pa c <br /> 6.Si ure: (Addressee or Agent) ~ . <br /> L <br /> 7 4 <br /> rn PS Form 3811,December 1994 102595-98-13-0229 Domestic Return Receipt <br /> Z 442 198 930 \" <br /> US Postal Service <br /> Receipt for Certified Mail <br /> No Insurance Coverage Provided. <br /> Do not use for International Mail(See reverse <br /> Sent to /1 <br /> Street&1 u0 J / <br /> Post Office, dy <br /> Sta�& 625 <br /> Postage $ /3 5 <br /> Certified Fee 1 f o <br /> Special Delivery Fee <br /> Restricted Delivery Fee <br /> 0) <br /> rn Return Receipt Showing to <br /> r Whom&Date Delivered <br /> a Return Receipt Showin <br /> Q Date,&Addr <br /> TOTAL age&Fe <br /> Go <br /> 0 Postm rk or` <br /> € <br /> i t <br /> d v b <br />