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, � __ . <br /> . . . . . . . <br /> ■ Complete items 1,2,and 3.A�so complete A. signa "` <br /> item 4 if Restricted Delivery is desired. X ❑Agent <br /> ■ Print your name and address on the reverse Addresse� <br /> so that we can return the card to you. B. Re eiv d by f R'n Name) C. �at of Delivei <br /> ■ Attach this card to the back of the mailpiece, 1 � � <br /> or�n the front if space permits. �� <br /> ' ' D. Is delivery address different from ttem 1? ❑���---rrrrrrYes <br /> 1. Artic19 Addressed to: If YES,enter delivery address below: yp No <br /> .,� � � <br /> K-e.��� �- V�and►y �chu��- <br /> 3q� C,h�Xry f�� <br /> ��,AAA��1 3. Se ice Type <br /> �r�►' � �� `%���� �Cert�ed Mail ❑Express Mail <br /> 1!VI. '(�`�I <br /> ❑Registered ❑Retum Receipt for Merchandise <br /> ❑Insured Mail ❑C.O.D. <br /> 4. Restricted Delivery?(Extra Fee) ❑Yes <br /> 2. Article Number <br /> (Transfer from service label) 7�0 7 �2 2 0 �0 0� 19 8 9 814 2 <br /> ; PS Form 3811,February 2004 Domestic Retum Receipt 102595-02-M-15ri0 <br /> -• , ,• � - `\J` . <br /> � I� • <br /> � <br /> Q' L �„„, � <br /> �9 <br /> �' Postage $ � �oA' <br /> rl y <br /> Certified Fee 2, 5 c. �y` ' � ,, <br /> 0 � aoumark .�, <br /> 0 Retum Receipt Fee y�e � <br /> O (EndorsementReqwred) Z,� � GY' m <br /> � Restricted Delivery Fee � '� <br /> � (F.ndorsement Required) _ ��, r.3 �� <br /> � 9 �.J i ," , .,..�.�,, � <br /> fU Total Posta e&Fees ' <br /> p v "`�l <br /> � Sent To � . <br /> o -------ICe.l11Y�._�-_I.��1�_---�u�-�------------- <br /> � Street.A f�,�� <br /> � orP,�;: , �x nrQ� <br /> �o -- �N� --------------,---------- <br /> C1ry.�r ��-� � <br /> :�� ��. <br />