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■Complete Items 1 and/or 2 for addlt;onai services. I also wish to receive the <br /> 'N ■Complete Items 3, 4a, and 4b. following services (for an <br /> a Print your name and address on the reverse of this form so that we can return this extra fee): <br /> card 10 you <br /> ■Attach this form to the front of the mallplece, or on the back it space does not f, C] Addressee's Address <br /> permit <br /> y ■Write'Retum Receipt Requested'on the mallplece below the articie number. 2 ❑ Restricted Delivery �} <br /> aThe Return Receipt will show to whom the article was delivered and the date «, <br /> C delivered. Consult postmaster for fee a <br /> 3 Article Addressed to: 4a. ArV le Number <br /> ? fir, <br /> � � <br /> .{i 41 E <br /> I L � �� <br /> E •If J - i ..� 4b. Service Type a <br /> ❑ Registered . Certified Wo <br /> W i.� ❑ Express Mail ❑ insured H <br /> cn <br /> o c Retum Recelpt for Merchandise ❑ COD <br /> 7 Date of Delivery <br /> z <br /> 5. Received By, (Print Name) 8 Addressee's Addre s (On y if requested <br /> and fee 1s paid) <br /> 6 Signatur : (A#drj9sse9 or Awnt) <br /> ar X <br /> H <br /> �' PS Form 3811, December 19,94 Domestic Return Receipt <br />