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Q <br /> 43 <br /> why <br /> Po <br /> or Certified Mail CA0 <br /> No insuranc Coverage Provided <br /> Do not use for International Maii tSee reverses <br /> to CLi \ n <br /> Street&Nu b r <br /> rj � <br /> Post Office,State,&ZIP Code t <br /> > %\ <br /> Postage $ <br /> Certified Fee <br /> Special Delivery Fee <br /> Restricted <br /> rn r`. <br /> Returerfie <br /> Wh d Ke Delivered A • <br /> a R rn Receipt Showing to Whom, <br /> Q D te,&Address ee'6 Address <br /> 0 TQTAL Ri <br /> M Postmark or Date <br /> LCO . <br /> CO .r <br /> a <br /> SENDER: <br /> v ■Complete items 1 and/or 2 for additional services. 1 also wish to receive the <br /> rn ■Complete items 3,4a,and 4b. following services(for an <br /> a) ■Print your name and address on the reverse of this corm so that we can return this <br /> card to you. extra fee): <br /> > ■Attach this form to the front of the mailpiece,or on the back if space does not 1. El Addressee's Address <br /> permit. <br /> y ■Write'Retum Receipt Requested'on the ma 1piece'below the article number. 2. ❑ Restricted Delivery to <br /> r ■The Return Receipt will show to whom the article s delivered and the date ., <br /> delivered. Consult postmaster for fee. E� <br /> c 'd <br /> 3.Article Addressed to: 4a.Article Number d <br /> a; tr <br /> a <br /> E 4b.Service Type <br /> ° �V\q `c�r \6q ❑ Registered Certified cc <br /> ) t JJ �ti< rn <br /> (n �} ❑ Express Mail ❑ Insured .O <br /> ol3 0� Return Receipt for Merchandise ❑ COD <br /> 0 7.Date of Delivery <br /> _ - T <br /> p 5.Received By: (Print Name) 8.Addressee's Address(Only if requested <br /> Uj and fee is paid) 1°c <br /> g 6.Signature: (Addres ee r gent) <br /> >` X <br /> PS Form 381 December 1994 Domestic Return Receipt <br />