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COMPLETE SECTIONCOMPLETE THIS SECTIONON <br /> ■ Complete items 1,2,and 3.Also complete Signature l <br /> item 4 if Restricted Delivery is desired. f', // ❑Agent <br /> ■ Print your name and address on the reverse L f Yf ❑Addressee <br /> so that we can return the card to you. R Received by(Printed Nam ) 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 /> p3AOC Y ¢ \1,,Pgl kW14Hr <br /> ,n$ 7DN Oki <br /> ¢OAt <br /> {.'Aj� 4*� ~tN/ '575 315& 3. Servi e Type <br /> Certified Mail ❑ Express Mail <br /> Registered ❑ Return Receipt for Merchandise <br /> ❑ Insured Mail ❑ C.O.D. <br /> 4. Restricted Delivery?(Extra Fee) ❑Yes <br /> 2. Article Number 7 11 5� dOGy ��Tp^910 `WO <br /> (Transfer from service label) `iV/'�!! <br /> PS Form 3811,August 2001 Domestic Return Receipt 102595-02-M-1540 <br /> (DomesticU.S.Postal Service <br /> CERTIFIED MAIL RECEIPT <br /> Only; <br /> O <br /> r-R <br /> lti <br /> r-R <br /> ❑ Postage $ , PA-BA y <br /> CID <br /> EZI Certified Fee <br /> Lr) V <br /> `� Postmark <br /> Return Receipt Fee 9H�o <br /> 1--3 (EndorsementRequired) SEp � y <br /> O Restricted Delivery Fee t <br /> C3 (Endorsement Required) <br /> O Total Postage&Fees $ <br /> fL J <br /> fl I Name(PleaLCarly)ty)(To be completed by maile"' _-_fiVDy -!c/�[bftTStreet,Apt. x No. <br /> -------- ---------------------� �v�----------------C`- City Ste e, � ,•.. / 15 <br />