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SENDER: <br /> y Complete items 1 and/or 2 for additional services. <br /> I also wish to receive the <br /> y • Complete items 3,and 4a&b. following Services (for an extra m <br /> E • Print your name and address on the reverse of this form so that we can fee): <br /> > return this card to you. ` . <br /> d • Attach this form to the front of the mailpiece,or on the back if space 1. ❑ Addressee's Address a) <br /> does not permit. y <br /> t • Write"Return Receipt Requested"on the mailpiece below the article number. G <br /> " • The Return Receipt will show to whom the article was delivered and the date 2. ❑ Restricted Delivery <br /> 0 delivered. Consult postmaster for fee. a) <br /> m 3. Article Addressed to: 4a. Article Number i <br /> E ik r, ��Q n ��K eQ K� � 4b. Service Type <br /> c0i ❑ Registered ❑ Insured <br /> y ��`� QX WC-ertified ❑ COD c i <br /> ra <br /> W / E ❑ Express Mail ❑ Return Receipt for <br /> M I �� / K Merchandise <br /> . Q 01 7. Date of Delivery � <br /> 0 <br /> z5. Signature (Addressee) 8. Addressee's Ad ress (Only if requested Y <br /> and fee is paid) <br /> LU <br /> 6. Signatu t1 yam H <br /> 0 <br /> y PS For , December 1991 *U.S.GPO:1992-323-4m DOMESTIC RETURN RECEIPT <br />