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17C-049 U.S. Postal ServiceTM CERTIFIED MAJLTM RECEIPT r-i CD (Domestic Mr 11 Only; No insurance Coverage Provided) m For delivery Int3rmation visit our website at www.usps.come Postage $ Certified Fee lirnark rm Return Receipt Fee i)17y:l Nelms (Endorsement Required) _ nestricted Delivery Fee 0 (Endorsement Required) r-9 Total Postage & Fees $ S 1:3 teph elv R Heekio MA> N Street, Apt. No.; 9 f FA -pr or PO Box No. City, State, Z1P+4 l- t11/4 PS Form 3800, June 2002 See Reverse tor Instructions ((+`( rrt( rlftfirtt r1rr( t risr ( jtitss rtrstttist !!I(stitttt!` ,I Le i(bNtZ /Z $WG,13 - 3dSNI ONi014118 1.:.+ O d VRI N:OMJ t f 'RA s\\) u\ V+d\Z pue `SSaappe `auasu ano& luiad aseetd :aaPuaS ov0 'oN Plad SdStl 33I l`d1SOd S31diS (331114n ied saa4 4elsod p \g�sse�� -1s�i� n �ai�l 11 �1"IQt�, I% :7; 7 "/S SECTION ON DELIVERY �� A S�9na anth G��Q A CI Agent �� dressee 1 Cd f y o u. eceiv by (Printed = e) C.�ate�o � iliii5;11116111" IS Car to the back of the II • ¢ _ >- l , or on a front if space permit r tr, �;:. �. ti t -- - Or , �, D. Is delivery address differe • ❑ Na 1. Article dressed to: if YES, enter delivery address below: r S ' ROL Sie eit) xaPIAA) D ��r °119 9- 3. SecvIceTyPe resa Mail /©if e-A)t, I`v 144 Gertttied M att Q mum Receipt Me �handise r 1 ❑ Registered n G.O. 0 insured Mail a=ces �1. etip`N Feel - 1540 � � � 3p1y 1025 1 diQo � _ckeodipt