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.� � � i <br /> �,� , S� l 1'��" �f�� <br /> � • <br /> � , . . . <br /> e �omplete 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 X �❑Addressee <br /> so that we can return the card to you. B. Received by(Printed Name) 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 delivery address different from item 1? ❑Yes <br /> 1. Article Addressed to: If YES,enter delivery address below: ❑ No <br /> ]V�A,ur�+n �� �fe.�n <br /> ��o ���. �`�-- � <br /> �pYl/�71� �,(��1.� I'�1`� ���x 3. SQrvice Type <br /> 1 `� ��9C<<j rtified Mail ❑Express Mail <br /> �'���W VO Registered ❑Return Receipt for Merchandise <br /> ❑Insured Mail ❑C.O.D. <br /> 4. Restricted Delivery?(Extra Fee) O Yes <br /> 2. ArticleNumber 70�2 Q510 0�01 63�6 0322 <br /> (rransfer from servke lab <br /> PS Form 3811,February 2004 Domestic Return Receipt 102595-02-M-1540 <br /> r <br /> . , . : (Z,G'„ 2t�5 f� �fi i?d <br /> • ��.?' <br /> .. - . _ � _ <br /> �, � _ _.. . <br /> �, . <br /> m <br /> o _ _- • <br /> `n Postage $ 0�� <br /> o ygTAL e� ' <br /> m Z.�� <br /> _p Gertified Fee �Q ostmark � <br /> (�ere � <br /> ,-a Return Receipt Fee /J �f n �i��p <br /> � (Endorsement Reqwred) ` L''L� � � Z <br /> � Restricted Delivery Fee <br /> � (Endorsement Required) �D�B � <br /> � rotal Postage 8 Fees $ ..J�� GsAtS ��� <br /> � Sent To y���--�pn✓�-- �. ,��1.V`I�w I 1 - -- ------ ------- <br /> I��uU �xa , <br /> ---- -- ---- - <br /> fLl .Street.Apt.No.: �� Q •1r� �c�/`�r� <br /> O or PO Box No. JI v -_- <br /> — <br /> -- --- <br /> ---------.. <br /> --- -- -----�\ V <br /> ----- 1� <br /> � City,State,ZIP+4 <br /> l'`-. <br /> 1� <br />