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� • <br /> . , <br /> . , <br /> . . . <br /> ■ Complete items 1,2,and 3.Also complete A. Signature <br /> item 4 if Restricted pe�iveq,�g desired. <br /> ■ Print your name and address on the reverse X� �'� ❑Agent <br /> so that we can retum the card to you. ❑Addressee <br /> ■ Attach this card to the back of the mailpiece, B• ecelve�t��printed Name) C. Date of Delivery <br /> or on the front if space permlts, f��A?�:- f�� j � <br /> � <br /> 1. Art(cle Addressed to: D. Is delivery eddress diftereM fiom Item 11 ❑Yes <br /> If YES,enter delivery address bs�ow; ❑No <br /> i��'h� �� I i.s <br /> � f`0 L�IV�' UJ"'`-' �Y'v 3. T <br /> � � <br /> iN� �Ceitlfled Mail ❑Express Ma(I <br /> ��,� �N ���� -0 Registered ❑Retum RecelptforMer�handise <br /> ❑Insurod Mall ❑C.O.D. <br /> 4. ResUicted DeliveM(Ex�ra Fee) ❑Y� <br /> 2- Article Number <br /> (r�tro►nsarv�,�ape� 7007 0220 �00� 1987 6829 <br /> PC Fnrm 4S2i 1 r - <br /> . _..,......v� �,rex�►uary"LUU� DOrtlesUc R6tUR1 R9CBIpt . <br /> 102596-02-M-0540 <br />