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� <br /> �. <br /> ��;.p � � " 1�1_,t`} '�Fi. . <br /> � � � � <br /> � • • <br /> ■ Complete 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. g, 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 /> �����. C�.ur��� <br /> ���I ��� �� 3. ice Type <br /> �rtified Mail ❑ Express Mail <br /> `^1� ��y� ��j ,��J ❑Registered ❑Return Receipt for Merchandise <br /> yv � �1��" ❑Insured Mail ❑C.O.D. <br /> 4. Restricted Delivery?(Extra Fee) p Yes <br /> 2. ArticleNumber 7Q02 �51� 0001 63�6 0377 <br /> (riansfer from service label) <br /> PS Form 3811,February 2004 Domestic Return Receipt 102595-02-M-1540 <br />