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f � � � <br /> , . � � f I 1 <br /> ■ Comp�ete items 1,2,and 3.Also complete A. Si ac�,,re <br /> item 4 if Restricted Delivery is desired. � ❑Agent <br /> ■ Print your name and address on the reverse Addressee <br /> so that we can return the card to you. g, eceived by(Printed Name) C. Date of Delivery <br /> ■ Attach this card to the back of the mailpiece, � ^� ' <br /> or on the front if space permits. <br /> D. Is delivery address different from item 1? ❑Yes <br /> 1. Article Addressed to: If YES,enter delivery address below: ❑No <br /> 3. Service Type <br /> ❑Certified Mail ❑Express Maii <br /> ❑Registered ❑Return Receipt for Merchandise <br /> ❑ Insured Mail ❑C.O.D. <br /> 4. Restricted Deliveryl(Extra Fee) ❑Yes <br /> 2. Artic�eNumber 7002 Z41,0 0002 9881 3355 <br /> (Transfer 1rom service label) <br /> ; PS Form 3811,February 2004 Domestic Return Receipt 102595-02-M-1540 1 <br /> ' • "i <br /> � � , � � , J <br /> u� � - • <br /> m '' , <br /> m <br /> a - <br /> � <br /> �o <br /> �' Postage $L o�o.3 �ONG �AK�,�A_ <br /> � Certified Fee ��v <br /> O ' ' Postmark <br /> � Return Reciept Fee �� MAY 1 �e��s <br /> � (Endorsement Requved) <br /> O Restricted Delivery Fee <br /> � (EndorsementReqwred) � 'sp _�`� <br /> \ <br /> � Total Postage&Fees $ —\•- CJ� �..S - 553'' <br /> � — <br /> o ���ro :�2.�c �•R�� .� 11A ���.teQ� � .��� <br /> � -------------------------------------------------------------------------- <br /> C� Sfreet,,4pt.No.; .� �A r r� � f� N Q <br /> or PO Box No. <br /> -�--------�-------------------------------------------------- <br /> City,State,TJP+�� �r � „ ��� �i�N� � � � �� <br /> L._ f� <br /> :�� �� <br />