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COMPLETE <br /> ■ Complete items 1,2,and 3.Also complete A. W;U <br /> item 4 if Restricted Delivery is desired. X ❑Agent <br /> ■ Print your name and address on the reverse ❑Addressee <br /> so that we can return the card to you. B.;F�7i� b (P' ted e) D to of Deli ery <br /> ■ Attach this card to the back of the mailpiece, , 7 <br /> or on the front if space permits. <br /> D. Is dehv ry address different from item 1? ❑Yes <br /> 1. Article Addressed to: If YES,enter delivery address below: ❑ No <br /> �In�ll. CQrlson <br /> ��� 3. S ice Type <br /> 111 v rfied Mail ❑ Express Mail <br /> Registered ❑ Return Receipt for Merchandise <br /> �V`N <br /> 11 Insured Mail ❑ C.O.D. <br /> 4. Restricted Delivery?(Extra Fee) ❑Yes <br /> 2. Article Number 7002 0510 0001 6306 1282 <br /> (Transfer from service label) <br /> PS Form 3811, February 2004 Domestic HL-turn Receipt 102595-02-M-1540 <br /> Wa Offik-L <br /> ru <br /> ru <br /> ruU.S. Postal <br /> CERTIFIED MAIL RECEIPT <br /> OPostage $ e <br /> M <br /> /� _ (Domestic • • .•• • • ••• <br /> —0 Certified Fee •/ —$09�Pte® ED <br /> a Return Receipt Fee fjt-,•�O r <br /> O (Endorsement Required) <br /> O <br /> Restricted Delivery Fee QC' Gff- <br /> O (Endorsement Required) j� -D <br /> O IMF m Postage $ e wy�I�,' BA <br /> ,q Total Postage&Fees $ �. u(/ Certified Fee �� PostmarkLn �"�i <br /> O Se • . � Return Receipt Fee <br /> r'` N 'A/ Here <br /> --- �----�_ �{ Y�_ ■ ,(------- ---------------- p (Endorsement Required) v U O�l ri BA'Lu Rl <br /> p --- 4 fNbf <br /> ru Str t.No. O Restricted Delivery Fee <br /> M or O (Endorsement Required w <br /> O ) <br /> Ci te,ZIP+4 C3 $ <br /> '-a Total Postage&Fees <br /> Lin <br /> O Sent <br /> j ---- --------- `.C• <br /> flJ S[reet o�Q///� <br /> O or P('W" Y ---!-- -- �-------- <br /> C7 City et ZIP M,� , <br /> ff <br />