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{ <br />a ° <br />N ❑ Complete items 1 and/or 2 for additional services. <br />yComplete items 3, 4a, and 4b. <br />E3 Pont your name and address on the reverse of this form so that we can return this <br />d card to you. <br />o Attach this form to the front of the mailpiece, or on the back if space does not <br />d permit. <br />t o Write -Return Receipt Requested"on the mailpiece below the article number. <br />e ❑ The Return Receipt will show to whom the article was delivered and the date <br />o delivered. <br />m 3. Article Addressed to: 4a. Article Nur <br />v <br />E <br />4b. Service Ty <br />I also Wish to receive the follow- <br />ing services (for an extra fee): <br />m <br />1. ❑ Addressee's Address <br />2. ❑ Restricted Delivery N <br />0 JON BEARD ❑ Registered <br />N PO BOX 739 $ ❑ Express Mail <br />W <br />EMPIRE CA 95319 ❑ Return Receipt for <br />a7. Date of Delivery <br />zltm-, I <br />5. Received By: (Print Name) 18. Addressee's Ad <br />fee is paid) <br />6, S&ature (Addressee o gent) <br />0289$ <br />PS For 11, December 1994 t =es?a rte ` ` sti <br />G <br />ertified <br />�d <br />❑ nsured <br />c <br />erchandise ❑ COD <br />�y <br />L <br />— <br />o <br />w r <br />c <br />(Only if requested and <br />cc <br />0289$ <br />PS For 11, December 1994 t =es?a rte ` ` sti <br />