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| Title | U.S. Stamped Envelope Agency |
| FormNumber | 3218 |
| Revision | c1893 |
| Division | |
| WhereUsed | Packing slip and receipt to accompany a shipment from the Agency to a postmaster |
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| LKU | |
| Notes | Top portion of form only. This example used from Hartford, CT. |
| Source | don |
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