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SENDER:
~rnPlete !tems 1 ancllor 2 for additional services
- . mplete Items 3. 4a. and 4b. .
: nr~t t~~;~ame and address on the reverse of this form so that we can return this
pe~~. this form to the front of the maifpiece. or on the back if Space does not
- Write 'Return Receipt Req ted' . .
-The Return Receipt will Sh~~to w~~~h~:artll~cllece below. the article number.
delivered. a I e was delivered and the date
3. Article Addressed to:
LXr9 //J,'C1 JJ-h A c) I d
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/Ue.e-/1.cAl Lv.' S' <7'96,=
I also wish to receive the
following services (for an
extra fee):
1. 0 Addressee's Address
2. 0 Restricted Delivery
Consult postmaster for fee.
4a. Article Number
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b. Service Type
o Registered Er Certified
o Express Mail 0 Insured
o Return Receipt for Merchandise 0 COD
7. Date of O~ivery
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8. Addressee's Address (Only if requested
and fee is paid)
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Domestic Return Receipt