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� �� �r�IU �;� t� <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 �.� - � rF-� �Addressee <br /> so that we can return the card to you. g, e eiv Printed Na 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 deiiv address different from item 1? ❑Yes <br /> 1. Article Addressed to: If YES,enter delivery address below: ❑ No <br /> � <br /> Jc��'V'1� � �- I'��V`� � ��-i� '.: , <br /> �'2�'0 VJ ��� �"�� 3. Service Type <br /> 5���i,, /��-7 � �'] �ertified Maii ❑Express Mail <br /> 1� I"f L $�1�Z ��� 1- t ❑ Registered ❑Return ReceiptforMerohandise <br /> ❑ Insured Mail ❑C.O.D. <br /> 4. Restricted Delivery?(Extra Fee) ❑Yes <br /> 2. ArticleNumber 7p07 022� 000� 1990 9428 <br /> (fransfer from service label) <br /> PS Form 3811,February 2004 Domestic Return Receipt 102595-02-M-1540 <br /> � � " �� �r��� �'°M� <br /> m ' � , ,... ,. <br /> ru �• . <br /> � <br /> o, <br /> �� �;� � � �y � �' <br /> f � h � , <br /> o �,° �'.� � � � d�� - � <br /> o-� .� �> <br /> � Posta e $ �T <br /> � 9 ��- -�, �a...,. C� <br /> � Certifled Fee �7 �j(� b� �, ��� <br /> � /�� 0 W.� l!� <br /> � Return Receipt Fee �ostmeNcl L� <br /> � (Fndorsement Requlred) � 3 '�F-' � Here � � <br /> Restricted Delivery Fee 7" � � <br /> p (Endorsement Required) (� � _Q/ <br /> fLJ 7 ' <br /> � Total Postage&Fees � 5,5¢ <br /> O <br /> O SentT J�rnv �--�- �r`I-- � . �` �(�� <br /> � Street.A,pt_.N9-r------------ ---'----"' ---t '-------t'J��-=O-="-----------�-- <br /> � or PO�kA�61.5Q n t/�['] <br /> ---- —�``-1_S.J�4G--'-�j� v <br /> City St e.ZIP+ ---'-�� r----.'--•--"'---"---------•'-----' <br /> :,, ,,. <br /> �- �Z(cZ 5�2� <br />