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r.. <br /> o wish to receive the <br /> .71 e„ 1 a dfor addit nal services. <br /> following services tfor an extra <br /> (at items 3,and 4a&b. that we can At 0 AUG 0 81995 <br /> j J <br /> s Fvnt your name and address on the reverse th' Addressee's Address <br /> Q+ return this eatd to you t k if Space a <br /> .. <br /> > • Attach this form to the front of the ma,piec 2 Restricted Delivery m <br /> 4 4 does not permitnumber, V <br /> C 40 . Write"Return Receipt Requlestad'^on the mailpiece below the article toConsult postmaster for fee. tY <br /> M r r . The Return Receipt will show to whom the article was delivered and the date = <br /> Mo n deii�ered. 4a. Article Number <br /> C -a 3. Article Addressed to: T / + m <br /> 117�� - Y OLL 4b. Service Type <br /> MARIE CARL. ❑ Registered ❑ tnsured 0 <br /> Q' CARROLL [ICoo <br /> E <br /> RI & Certified co <br /> r°s 443 SYCAMORE LN rens Mail [� Ret"rn Receipt for <br /> r0 0 <br /> 95336 <br /> Exp Marc dies - o <br /> �� r+Ip,NTECA CA7. pate of D 3 <br /> 0 <br /> r <br /> N� ddres Only if requestel G <br /> r Q <br /> B. Address <br /> d fi Id) `6 <br /> an <br /> t <br /> z 5. Si nature (Addressee} p h <br /> r <br /> 6. Signature (Agent) <br /> 7- PS Form $811.December 1991 itU.s.Gpo:le93-352 I D ESTIC RETURN RECEIPT <br /> 2 - - <br />