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1 I , <br /> � � � � � <br /> � � � <br /> ■ Com lete items 1,2,and 3.Also comp�ete A. Sicfnatur ' <br /> p � ,f,, ,;'11 (, lj ❑Agent <br /> item 4 if Restricted De�ivery is desired. X � �� J ❑Addressee <br /> ■ Print your name and address on the reverse <br /> so that we can return the card to you. e. Re ve y(P'nted Name) C. Date of Delivery <br /> ` ■ Attach this card to the back of the mailpiece, ``��_�v K,�" 4 ` � C ��-c <br /> or on the front if space permits. �J <br /> D. Is delivery address different from item 11 ❑Yes <br /> 1. Ar'cicle Addressed to: If YES,enter delivery address below: ❑ No <br /> Jef�� �. C�le� <br /> � <br /> (��� �� �d 3. Service Type <br /> Z�q� \.x�`^ �Certified Mail ❑ Express Mail <br /> ❑ Registered ❑ Return Receipt for Merohandise <br /> UJ'��� �� ���I ❑ Insured Mail ❑C.O.D. <br /> n oe��.�,.+,..+n,.�:..,...n��..,_.� ❑YeS <br /> 2. Artic <br /> (rrar <br /> .J2595-02-M-1540 <br /> PS For <br /> � ' , . ��� <br /> � <br /> .. <br /> , , _ . :: .. . <br /> � <br /> � <br /> a <br /> ..D G KF ,y� <br /> 0 Postage $ AI <br /> rn /� � � <br /> �p Certified Fee '/ . postmar <br /> 4 <br /> � Return Receipt Fee /� ' �� � � 7(��re <br /> � (Endorsement Required) (� Lw�� <br /> � Restricted Delivery Fee � <br /> 0 (Endorsement Required) �Q � <br /> o S'p _ c��`�h <br /> � Total Postage&Fees $ 5, � <br /> � Sent To T� ---------- �----- -- j <br /> --------J- - � �'--��--- - - -- - ----------- <br /> N Street.Apt.No.: ^ �/� /� /� ^�.� �. �/� <br /> O or PO Box No �/ ��� �.7� ��'{� <br /> —�-=— — �-- - - <br /> � City.State,ZIP+ `�'J`/v ,. <br /> N <br /> .1 11 <br />