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Z 128 782 638 <br /> Uri'-ostal Service <br /> Receipt-for Certified Mail <br /> B M SAMSON <br /> SUTTER OFFICE CENTER <br /> 2001 UNION ST #300 <br /> SAN FRANCISCO CA 94123 <br /> Postage 11 <br /> Certified Fee <br /> Special Delivery Fee <br /> M Restdcted Delivery Fee <br /> 0 Return Receipt Showing t <br /> _ Whom&Date Delivere <br /> a Return Receip Showing t <br /> Q Date, Addy ee's r <br /> O <br /> 0 TO Po F s <br /> M Post a <br /> E <br /> o` <br /> U- <br /> U) <br /> d <br /> r' $ ER: I also wish to re eive the <br /> ■Complete items or 2 for additional services. following Servic S(for an <br /> rA ■Complete iZ 3, a,a 4b. n� <br /> d ■Pdnt your n a d on the reverse�thiso ttaclutum this extra f nG 1rd to yo p d�55Attach thi f t i ack ifs ace do of 1.LLLJJJJ MR11A S���+++������reSS <br /> m pe rrnR. <br /> 2 •Wdte°Return Rec pt equested"on the mailpiece below the articl ber. 2.❑ Restricted Delivery to <br /> r ■The Return Recei show to whom the article was delivered to Consult postmaster for fee. a <br /> delivered. <br /> C 3.Article Addressed to: 4a.Article Numbe . <br /> T cc <br /> a B M SAMSON <br /> 4b.Service Type <br /> SUTTER OFFICE CENTER m <br /> 2001 UNION ST X300 El ertified � <br /> ❑ Express Mail Insured <br /> U SAN FRANCISCO CA 94123 ❑ Return Receipt for Merchandise ❑ COD <br /> [ 7. Date of Deli <br /> ve `o <br /> 'Z _ 'o <br /> 5. Received By: (Print Name) 8.Addressee's ddress (Only if requested Y <br /> and tee isp i a <br /> t <br /> 6. Signature: (Addressee or Agent) ~ <br /> i X t G <br /> =' PS Form 3811,December 1994 102595-98-B-0229 D nnestic Return Receipt <br />