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. � � � � f� � 1 I <br /> ■ Complete items 1,2,and 3.Also complete }�. 5ignature <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 beiow: ❑ No <br /> �en,�rn,n �- l:� Sertser� <br /> 2�45 � r�2 <br /> 3. Service Type <br /> 0�� M� �( �Certified Mail ❑Express Mail <br /> ❑Registered ❑ Return Receipt for Merchandise <br /> �Insured Mail �C.O.D. <br /> 4. Restricted Delivery?(Extra Fee) ❑Yes <br /> 2. Article Number <br /> (f2nsfer from service label) 7 0�2 0 51� 0 0 01 6 3�6 �3 0 8 <br /> PS Form 3811, February 2004 Domestic Return Receipt 102595-02-M-1540 <br />