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n. <br /> y <br /> v SENDER: <br /> y • Complete items 1 and/or additional services. I also vto receive the <br /> W • Complete items 3, and 4N..,. following s•,. es (for an extra u <br /> • Print your name and address on the reverse of this form so that we can fee): .` <br /> m return this card to you. m <br /> • Attach this form to the front of the meilpiece,or on the back if space 1. ❑ Addressee's Address <br /> m y <br /> does not permit. G <br /> V • Write"Return Receipt Requested"on the meilpiece below the article number. 2. ❑ Restricted Delivery •� <br /> C • The Return Receipt will show to whom the article was delivered and the date Consult postmaster for fee. <br /> C deliveredcc <br /> a 3. Articl - - d to 4a. Article Number E <br /> o =RODUCTIt,I 4b. Service Type cc <br /> E ATTN: LEWYN BOLERy ❑ Registered ❑ Insured <br /> 0 1000 E CHANNEL 5T. [?'Certified ❑ COD <br /> H <br /> w STOCKTON,GA 35205— ❑ Express Mail ❑ Return Receipt for <br /> W Merchandise <br /> `o <br /> p 7. Date of Delivery <br /> O = <br /> Q > <br /> 5. Signature Ad essea) 8. Addressee's Address(Only if requested <br /> and fee is paid) w <br /> F F <br /> R 6. Signat a (A <br /> 0 <br /> > PS Form 11, December 1991 *U.S.GPO:lsez�23-a DOMESTIC RETURN RECEIPT <br /> y <br />