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1149IN 3H1013do13AN3 JO d011tl 113)IOIiS 3Otlld <br /> SENDER: COMPLETE THIS SECTION COMPLETE THIS SECTION ON DELIVERY <br /> • Complete items 1,2,and 3.Also complete A. Signature <br /> item 4 if Restricted Delivery is desired. X 0 Agent <br /> • Print your name and address on the reverse 0 Addressee <br /> so that we can return the card to you. B. Received 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? 0 Yes <br /> 1. Article Addressed to: If YES,enter delivery address below: 0 No <br /> 15(ian t Homy <br /> ew �cz <br /> /� <br /> 3. Se Ice Type <br /> 21401 Pcv� ed Mail 0 Express Mail • <br /> ` y Registered 0 Retum Receipt for Merchandise <br /> CCS tJ I Or yt4'`/ �/1 xJ651 J,/ 0 Insured Mail 0 C.O.D. <br /> 1 •, 4. Restricted Delivery?(Extra Fee) 0 Yes <br /> 2. Article Number 7002 0510 0001 6306 0872 <br /> (Transfer from service label) <br /> PS Form 3811,February 2004 Domestic Return Receipt 102595-02-M-1540 i <br />