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� • � u,�. , <br /> � • i <br /> ■ Complete items 1,2,and 3.Also complete A �gna±ure . �h . <br /> item 4 if Restricted Delivery is desired. � <br /> ✓t^!� �„ �Agent <br /> ■ Print your name and address on the reverse �!�° : Addr ssee <br /> so that we cd�a return the card to you. B. Recei ed b <br /> ■ Attach this�ard to the back of the mailpiece, Y( inted Name) C.,,, of D live <br /> or on the frpnt if space permits. S <br /> 1. Article Addressed to: D. Is delivery address different from item 1? Ye <br /> If YES,enter delivery address below: ❑ No <br /> l��u� �A�r�y ��'� <br /> 2l�d C��o Pornrr- � <br /> �'r�� 7 �/���' •_ ` � _� /7/y 3. Service Type <br /> �Certified Mail ❑ Express Mail <br /> i <br /> O Registered turn Receiptfor Merchandise <br /> ❑ Insured Mail .O.D. <br /> 4. Restricted Delivery?(Extra Fee) ❑ Yes <br /> 2. ArticleNumb� 7p�2 2410 0�02 9881 3102 <br /> (Transfer frorr <br /> PS Form 381 1,August 2001 Domestic Return Receipt 102595-02-M-1540 <br /> . � <br /> � � � � � <br /> O <br /> rl �. � <br /> m <br /> � � �-R � . <br /> �:, <br /> w E• �s� r � �� <br /> � �� �:� <br /> o— /�/� t� <br /> Postage $ .V'�/��J r `J� . <br /> IlJ <br /> p Cert'rfied Fee �� � <br /> � P t ark <br /> p Retum Reciept Fee � � <br /> (Endorsement Required) � 7 i� 2 4 2 7.6 <br /> � Restricted Delivery Fee <br /> � (Endorsement Required) \ <br /> �' t�.� . <br /> � Total Postage&Fees $ ��j U p� <br /> F��y <br /> _ 5- <br /> � Sent T �I �� � <br /> O <br /> r" St�eef.-----o•--------�--�--y-�---- - ------------------------------------ � <br /> � <br /> l.(�A -- -----f-�. <br /> or PO e�� � <br /> ------ — __�— -._�- <br /> g .�l -`------------- i <br /> c,ry, r, G�GV)l� M 1J 'r7tJ3°l I � <br /> :�� �� <br />