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r.. <br />SENDER: <br />'y • Complete items 1 and/or 2 for additional services. <br />m • Complete items 3, and 4a & b. <br />cE • Print your name and address on the reverse of this form so that we can <br />CD return this card to you. <br />m • Attach this form to the front of the mailpiece, or on the back if space <br />does not permit. <br />t• Write "Return Receipt Requested" on the mailpiece below the article number <br />"' • The Return Receipt will show to whom the article was delivered and the date <br />I also wish to receive the <br />following services (for an extra <br />fee): <br />1. ❑ Addressee's Address <br />2. ❑ Restricted Delivery <br />C delivered. ( Consult postmaE <br />3. Article Addressed to: <br />CL <br />+e- <br />t° H"TTh 11 l r. L�tu.r I PV <br />�� t k <br />Lu 3 Gz� )'lei s l e. <br />a �+� LID v i Sj <br />I8�7 <br />Oct 5. Signature (Addressee) <br />1` <br />LU <br />6. Signature (Agent <br />0 <br />4a <br />Article Number <br />P ago-171 <br />for fee. <br />g-1 d 4 <br />4b. Service Type 0 <br />❑ Registered ❑ Insured Ix <br />0 <br />XCertified ❑ COD c <br />❑ Express Mail ❑ Return Receipt for M <br />Merchandise <br />7. Date of Delivery w <br />0 <br />8. Addressee's Address (Only if requested Y <br />and fee is paid) <br />�o <br />s <br />H <br />y PS Form 3811, December 1991 *U.S.GPO:1993-352-714 DOMESTIC RETllRn1 oc�e� <br />