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Form 3806-S (Rev AN V-51) 215PM 1554
Postmaster per
Receipt for Registered Article No.
POSTMARK
Fee paid 30 it cents. Class postage /
NN
Declared value Surcharge paid, $
Return Receipt fee
Spl. Del'y fee
Delivery restricted to addressee:
in person
, or order
Fee paid
FRED
Accepting employee will place his initials in space
indicating restricted delivery.
07-16-19433-5
GPO
NOTICE TO SENDER-Enter below name and address of addressee as an identification. Preserve and submit
this
in
case
of
or
for
has receipt (Name Carmela of addressee) injury application Scambra indemnity. (P. O. and State of Winsted address)
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Context sent to Scholar
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