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SENDER: I also wish to receive the <br /> • Complete items 1 and/or 2 for additional services. following services (for an extra <br /> • Complete items 3,and 4a&b. <br /> • Print your name and address on the reverse of this form so that we can fee): <br /> return this card to you. �. ❑ Addressee's Address <br /> i • Attach this form to the front of the mailpiece,or on the back if space <br /> does not permit. 2, ❑ Restricted Delivery <br /> • Write"Return Receipt Requested"on the mailpiece below the article number. <br /> • The Return Receipt Fee will provide you the signature of the person delivery Consult postmaster for fee. <br /> to and the date of delivery. 4a. Article Number <br /> 3. Article Addressed to: (��^ / a,�®�� <br /> �( �1 1 a 1 4b. Service Type l <br /> ❑ egistered ❑ Insured <br /> d ❑ COD <br /> r a 7 o <br /> ressee's d ss(Only if I ted <br /> 5. Sig ture (Addressee) fee is paid) it <br /> 6. ignature (Agent) <br /> PS Form Ski November 1990 trU.S.GPO:teal-287.088 <br /> DOMESTIC RETURN RECEIPT <br />