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: 1404 ldur rk- Rd <br /> . . . . . . . <br /> ■ Complete items 1,2, and 3.Also complete A. Signature <br /> item 4 if Restricted Delivery is desired. X � ,�/,/�//�, �� ❑Agent <br /> ■ Print your name and address on the reverse 1�'�� �y� l Addressee <br /> so that we can return the card to you. B. Received by(Printed Name) C. e of Pe��verv <br /> ■ Attach this card to the back of the mailpiece, <br /> or on the front if space permits. ' '� �- y' <br /> D. Is delivery address different from item 1? ❑ es <br /> 1. Article Addressed to: If YES,enter delivery address below: ❑ No <br /> ��ann�n i- 1Car� <br /> (v�; llor�rfih <br /> 2.ao g v�ic�� ��n � 3.�ce Type <br /> rtified Mail ❑ Express Mail <br /> ��� �� �^��� ❑ Registered ❑Return Receipt for Merohandise <br /> Y ❑ Insured Mail ❑C.O.D. <br /> 4. Restricted Deliveryl(Extra Fee) ❑Yes <br /> 2. ArticleNumber 7002 0510 0001 63�6 1350 <br /> (Transfer from service label) <br /> PS Form 3811, February 2004 Domestic Return Receipt 102595-02-M-1540 <br /> �• � �� <br /> � � • <br /> ' �arK-Rd <br /> .. . � P� <br /> o � <br /> �,., .. <br /> m <br /> a <br /> � <br /> p Postage $ � <br /> m �f � P•� M N SS <br /> ..p Certified Fee � � <br /> �. <br /> � Posteiark � <br /> r� Return Receipt Fee <br /> p (Endorsement Required) �. <br /> o --- p�� f <br /> � Restricted Delivery Fee �� <br /> (Endorsement Required) d , <br /> O J Q� <br /> ,� Total Postage&Fees , $ 5 i v5 <br /> tJ') _ ._ �'n/r. -------, <br /> n � - <br /> p SentTo ✓�+l�.Fj •.. l�R1� ._. •��(_� - <br /> Unln �- �� ! <br /> Of1J Street.Ac�.y4o� � � � � <br /> City Stat P`;- - ��------------. _..._ ._._ _ ---- ---------._--1 <br /> O - <br /> � � Qz� <br /> :., .. _ <br />