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. . . . . . <br /> ■ Complete items 1,2,and 3.Also complete � igna � <br /> item 4 if Restricted Delivery is desired. - Agent <br /> ■ Print your name and address on the reverse X �Addressee <br /> so that we can return the card to you. . Received b Print ame) ate of Delivery <br /> ■ Attach this card to the back of the mailpiece, ��ir e i �� <br /> or on the front if space permits. �t �� �`_�'�' <br /> D. Is delivery address different from item 1? ❑Yes <br /> 1. Article Addressed to: Ii YES,enter delivery address below: ❑ No <br /> IM iC�tq,Q,( � �ie.�h <br /> �" ��"�"�" ��� " _ 3. Service Type <br /> �� `�l� �� (`��� �ertified Mail ❑Express Mail <br /> J ❑Registered ❑ Retum Receipt for Merchandise <br /> j ❑Insured Mail ❑C.O.D. <br /> 4. Restricted Deliver�/T(Extra Fee) ❑Yes <br /> 2. Article Number <br /> n-�stert�mse� 7007 0220 0�00 1990 3891 <br /> PS Form 3811,February 2004 Domestic Return Receipt iozsss-oz-nn-isao <br /> . � <br /> . � � . . <br /> a <br /> Q. �. • <br /> � <br /> m - <br /> a <br /> � � , � , <br /> Q' Postage $ �� <br /> a — P.� MN <br /> 0 Certified Fee ��go � Ss� <br /> Q ` Return Recelpt Fee /� ^}� �Q Poq�rk (�w <br /> 0 (Endorsement Required) �.8V H �� <br /> Restricted Del(very Fee pQ�1 <br /> p (Endorsement Requlred) J <br /> � _�.. <br /> O Total Postage&Fees $^��4 '1QJQ� <br /> -- v <br /> QFSent----l�!!,S!!!"_!_.._.�_�_ -----e _•�_��- -- •-------------- <br /> p Stre t p <br /> ,� �",��0 -t'�1���''_�_r_��_�. -------------- <br /> City. e 1P ' � -�-- <br /> :� ��. - <br />