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i . <br /> • 1�' <br /> . �.7� <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 � ❑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 /> �a�ll�2 �nK- N� <br /> `� ��' ��Il� �IC'r� 3. Service Type <br /> u '� " � �ified Mail ❑ Express Mail <br /> ^ r LJ Registered ❑Return Receiptfor Merchandise <br /> �'�� ��.{ '�l�L ❑ Insured Mail ❑C.O.D. <br /> 1 � V <br /> 4. Rest�icted Delivery?(Extra Fee) ❑Yes <br /> 2. ArticleNumber 7Q02 0510 0001 6306 1190 <br /> (frensfer from servlce labe/) <br /> ; PS Form 3811,February 2004 Domestic Return Receipt 102595-02-M-1540; <br /> • • . D'(1���'�10n bt' <br /> , ' ' � <br /> ! q .if' � - <br /> � <br /> � <br /> !� <br /> � <br /> � Postage ��� `� ��� �vn� A� <br /> m �—__•_ '� 'Y//�� <br /> ,� Certified Fee �� i � � ^ <br /> Postmark �. <br /> ,� ;eturn Receipt Fee /�, 2 ���O�re � <br /> p (Endorsement Required) ��.J ._ <br /> � Restricted Delivery Fee � <br /> � (Endorsement Required) .. <br /> , � � <br /> � __ �,�1''' , <br /> � Total Postage&Fees �j 5��(J`l-0� <br /> i,r7 .._ -.- ��st',st--_'� . ..__. _. <br /> p Sent To ' —[`�.''A �M�� � <br /> Wv�►�1 !1 YJI 1�yJ ------- <br /> � I�rra ----- - <br /> --- — <br /> �1�1 Street,ApL No:��O ^11 � <br /> O or PO Box f�o. L�`� <br /> O ------- ----- T — <br /> � Ciry.State.ZIP� � � ��w,� <br /> � <br /> :11 �� <br />