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o- ND R: 1 also wish to receive the <br /> $ . plate nems an of 2 for add�'j a 'cos. following services(for an <br /> 0 ■ plate hams a.id and 4b. q(� e that we can return this extra fee): <br /> a1 r xiM your Hama end address 00000rfrrrSsssS tfttthhRRrte re rse <br /> Attach thu.s form to the front of the mailpiace,or on the back if space does not 1. El Addressee's Address <br /> ■wdetAatum Aece pt Requested"on the mailpiece below the article number. 2. ❑ restricted Delivery <br /> ■The Return Receipt will show M�{[tQF'the aq�de �@Uverad athdaty, Consult postmaster for fee. <br /> C delivered. HT i LUUU I i 1 v <br /> 0 3Articlsed to: 4a.Article Number a, <br /> C3 . e Addres /, 7t <br /> � 7 U <br /> CL 4b.Service Type m <br /> WALT DEN DULK ❑ Registered Certified <br /> cc <br /> r� <br /> RIPON KILLING E3 Express Mall ❑ Insured <br /> I <br /> P 0 BOX 180 E] Return Receipt for Merchandise ❑ CRD <br /> co <br /> ref IPON CA 95356 7.Date of De' ery <br /> y. <br /> N B.Addressee's Address(Only if requested m <br /> 5. eceived By: (Print Name) and fee is paid) h <br /> 6.Sig : (Addr see or g nt) <br /> a X <br /> Ps Form 3811, December 1994 <br /> ,oz5959,s..�,,y QQrilw�tic Return Receipt <br />