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� 1 <br /> � � I • a r � <br /> ■ Complete items 1,2,and 3.Also complete A. Signature <br /> item 4 if Restricted Delivery is desired. % _ ❑Agent <br /> ■ Print your name and address on the reverse ✓�Q l� Addressee <br /> so that we can return the card to you. ecei d by(Printed Nam) G,,IIa e f Delivery <br /> ■ Attach this card to the back of the mailpiece, <br /> or on the front if space permits. �`�� rn �� �� <br /> 1. Article Addressed to: <br /> D. Is delivery addness different from item 1? Yes <br /> If YES,enter delivery address below: ❑No <br /> �i�r�-- �• �leu�l,� <br /> Z�a� ��n�- 3. ice Type <br /> �ied Mail ❑Express Mail <br /> yUQ���,��,�� ��Regfstered ❑Retum Receipt for Merchandise <br /> ❑ Insured Mail ❑C.O.D. <br /> 4. Restricted DeliveryT(Extra Fee) p y� <br /> 2. ArticleNumber 7pp? 2680 00�2 3457 2�41 <br /> (iFansfer from service/abel) <br /> PS Form 3811, February 2004 Domesttc Return Receipt 102595-02-M-1540 <br /> . � <br /> � � i � ■ <br /> � I• • <br /> O - <br /> . . . : . . ., <br /> � - . .: . ,;, <br /> f� <br /> 1.1'1 <br /> � Postage $ <br /> m • yS�AL 8q y � <br /> Certified Fee � ` - <br /> � � Q Postmark � `\ <br /> p Return Receipt Fee n.� V Here �' <br /> p (Endorsement Required) ` iyqy �1 _ <br /> � Restricted Delivery Fee � � . <br /> Q (Endorsement Required) �?Q�Q �� ry <br /> `� � 5.1 ! GsAs � <br /> rp Total Postage&Fees <br /> f1J <br /> Sei <br /> O� � �.-- � �_--- <br /> -_ '--'----- ---'---'�---- <br /> '��.�� -------------------------•---- <br /> � �'•�T�� �a��� � <br /> rti _' <br /> �,�;�---,--. - r�i N `,�-! <br /> :, . � <br />