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^ I also wish to receive the <br /> SENDER: _ <br /> • Complete items 1 andlor 2 for additional services. following services Ifor an extra + <br /> H . Complete items 3,and 4a&b. <br /> fee): d + <br /> y! . print OW*1'# ou. <br /> >1l�l1N on the f9VerSa of this term so that we can ❑Addresseo's Address W ; <br /> y r urn this card to yau. <br /> or on the back if space i <br /> m .:Attach this tcrm to the front of the mailpiece, 2 ❑ Restricted Delivery 0 <br /> es not permit. 61 i <br /> m Write"Return Receipt Requested"on the mailpiece below the artic4e number. COnSUIt pOStmaSter for fee. � <br /> ax+ The Return Receipt will show to whom the article was delivered and the date <br /> CO aelivered. 4a. Article Number <br /> 3 <br /> m P293 132 <br /> rt.l -0 3. Article Addressed to: cc <br /> I. r' Y 4b. Service TYPe ❑ Insured a <br /> a DAN BI BREYNITY MEMORIAL ❑ Registered <br /> V Certified <br /> i O _ T RACY <br /> i (fie Mail ❑ Roprn Receipt for r <br /> m <br /> xgSPITAL ❑ Exp Merchandise i <br /> m •'r rvsjy 420 TRACY BLVD 7_ Date of Delivery 1g95 c <br /> a RACY CA 95376 LIAR � -19 <br /> - <br /> ca g, Addressee'sAdress(only if requested <br /> r eel r and fee is paid) <br /> t 5 nature l <br /> 1 � ` <br /> 6 gna re (Agent) 714 DOMEST{C RETURN RECEIPT y <br /> .li *U.S.GPO:1993^ - <br /> I` 3811.December 1991 <br /> y. pS Form <br />