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C : <br />• Complete Rams 1 and/or 2 for additional services.I also wish to receive the <br />• Complete items 3, and 4a & b. following services Ifor an extra <br />• Print your name and address on the reverse of this form so feel: <br />that we can return this card to you. 1. ❑ Addressee's Address <br />• Attach thle form to the front of the mailpiece, or on the <br />back if space does not permit. <br />• Write 'Return Rectal Regststed" on the mailpiece next to 2. ❑ Restricted Delivery <br />the article number. Consult postmaster for fee. <br />3. Article Addressed to: 4a. Article Number <br />V (0 8 .S'Y/ S 7 i <br />4b. Service Type <br />i <br />/1 / O O e t/ 7 a 7 ❑ Registered El Insured <br />��jc 0 Certified top COD <br />fM 5_ 69 1? ElExpress M Return Receipt for <br />Y () n �� 9���fMerchandise <br />7. Deo1 Qe ry <br />.U.S. GPO: 1M0-2I3II <br />is paidl <br />requested <br />RECEIPT <br />P 868 541 379 <br />Certified Mail Receipt <br />No Insurance Coverage Provided <br />Do not use for International Mail <br />(See Reverse) <br />moo <br />Steel & No <br />PO., Slate It ZIP Code <br />Postage <br />Cenaied Fee <br />6peciel Delivery Fee <br />Restrkled Delivery Feo <br />Return Receipt Stowing <br />to Whom & Dale Delnemd <br />Return Recepl Showing to Whom, <br />Dare. & Addmes of Delmery <br />TOTAL Postage <br />It Fees <br />Q <br />p <br />Postmark or Data <br />:sl <br />