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Jr A <br /> COMPLETE <br /> ON DELIVERY <br /> COMPLETE <br /> SECTION <br /> A S' n ure p Agent <br /> ■ Complete items 1,2,and 3.Also complete p Addressee <br /> item 4 if Restricted Delivery is desired. <br /> ■ Print your name and address on the reverse C. Date of Delivery <br /> so that we can return the card to you. B. Received by(Printed Name) / + <br /> ■ Attach this card to the back of the mailpiece, et/1 /PV t S Z A <br /> or on the front if space permits. D. Is delivery address different from item 19 0 Yes <br /> 1. Article Addressed to: If YES,enter delivery address below <br /> 0 <br /> O(�1 Vd 3. Service Type <br /> `�,J�J �ertrfied Mail 13 Express Mail <br /> ,�n^ Registered 0 Return Receipt for Merchandise <br /> 6 ^M I ✓❑' Insured Mail ❑C.O.D. <br /> �lJ� 1111,V ...JJJ"'� 111 4. Restricted Delivery?(Extra Fee) ❑Yes <br /> 2. Article Number <br /> 7002 0510 0001 6306 1275 <br /> (Transfer from service labs. Domestic Return Receipt 102595-02-M-1 540 <br /> PS Form 3811,February 2004 <br /> Postal <br /> RECEIPTCERTIFIED MAIL <br /> (DomesticOnly; <br /> Ln <br /> ru <br /> a <br /> D Postage $ ,44 <br /> C3 BAY M <br /> -D 2-- <br /> Qn <br /> M Certified Fee `_mark -y <br /> Return Receipt Fee �/� -�. Here tSs <br /> 2.� Q w <br /> C3 (Endorsement Required) v DEC 1 1 T009 ro <br /> C:3 Restricted Delivery Fee co <br /> 0 (Endorsement Required) K <br /> C3 Total Postage&Fees $ .✓ <br /> a <br /> Lr) <br /> ED Sent 70 <br /> ------_ - -- -- ----------- S.�.et--!- --- <br /> ---- - <br /> t1J City,State ZIP ��^///'''��� <br /> OL7 or PO B � � — <br /> - Z rn N .ss39� <br />