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SENDER: C 1&rr0PaCeesSF,rM 1+119% <br />tq a Cofnplale Items 1 and/or 2 for additional services. <br />m Cumplete iter" 3, 4a, and 4b. <br />cc <br />O Print your name and address on the reverse of this form so that we can return this <br />card to you. <br />d O Attach this form to the front of the mailpiece, or on the back if space does not <br />d permit. <br />r ❑ Write 'Return Receipt Requested'on the mailpiece below the article number. <br />O The Return Receipt will show to whom the article was delivered and the date <br />o delivered. <br />3. Article Addressed to: <br />I also wish to receive the follow- <br />ing services (for an extra fee): <br />1 • ❑ Addressee's Address <br />2. ❑ Restricted Delivery <br />:IC IVUIflutir <br />315 qZv aay <br />JON W BEARD ❑ Registered <br />PO BOX 739 ❑ Express m <br />EMPIRE CA 95319 ❑ Return Rec <br />7. Date of D41 <br />=1 5. Recei d By: (Pririt�Vame) <br />o <br />Mature dresse or enl <br />T � � <br />N <br />fee is paid) <br />ertiCr <br />P 19? ` ed rn <br />��-- Insured 5 <br />PS Fo n 9811, D4Qember 1994 102595-99-13-0223 <br />N <br />OD <br />_o <br />CO <br />IaUested and a <br />