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'ow <br /> SENDER: <br /> ;o <br /> •Complete items 1 anNor 2 for additional ssmoes. `^ I also Wish to receive the <br /> •+ Complete items 3,4a,and 4b. <br /> to •Print your name and address on the reverse of this form so that we can return this fOIIOWIng SBrvICeS(for an <br /> card to you. extra fee): <br /> j •Attach this form to the from of the mailpiece,or on the back it space does not tali <br /> permit. 1. ❑ Addressee's Address <br /> 4) •Wdte'Retum Recelpf Requesfed'on the mailpiece below the article number. y <br /> t„ •The Return Receipt will show to whom the article was delivered and the date 2 Restricted Delivery to <br /> delivered. <br /> G Consult postmaster for fee. <br /> ED UNSEALED d 3.Article��Ad//tl�ress�ed t�o: aa.ArticleNumbe <br /> ED DAMAGED <br /> ED WITHOUT 3� g �� ! ab.service Type 3 <br /> NTENTS C d? ❑ Registered �ertified M <br /> w _ / , /1' Z.SL ❑ Express Mail c <br /> ¢ (��(�t (_;f— ❑ Insured M <br /> G ❑ Return Receipt for Merchandise ❑ COD <br /> 7.Date of Delivery <br /> z <br /> F 5. Received By: (Print Name) 8.Addressee's Address(Only it requested c <br /> w and tee is paid) m <br /> 6.Signature: (Addressee or Agent) IL- <br /> j _0 X <br /> PS Form 3811, December 1994 102595-97-B-0179 Domestic Return Receipt <br /> I <br />