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� , . <br /> � . . . <br /> A. Si ture �� ❑Agent <br /> ■ Complete items 1,2,and 3.Also complete � <br /> item 4 if Restricted Delivery is desired. X ; ❑Addressee <br /> ■ Print your name and address on the reverse <br /> so that we can return the card t0 you. B. Received y(Printed Name) C. Date of Delivery <br /> ■ Attach this card to the back of the mailpiece> <br /> or on the ft'ont if space permits. p. Is delivery address different from item 1? ❑Yes <br /> 1. ARicle Addressed to: If YES,enter delivery address below: ❑No <br /> �`� O�� 1'' <br /> ��� ��K�^- - <br /> �� , _I�,� 1�N� 3. Service Type <br /> ��'i � �� �ertified Mail ❑Express Maii <br /> I ❑Registered ❑Return ReceiptforMerchandise <br /> `l�'n�'�n� �� �C� ❑Insured Maii ❑C.O.D. <br /> v\/V' f/w <br /> 4. Restricted Delivery?(Extra Fee) ❑Yes <br /> 2, Artic�eNumt�er 7pp7 p22D ���� 1,989 7671, <br /> (Tiansfer from service IabeQ <br /> PS Form 3811,February 2004 Domestic Retum Receipt ��-M-��o <br /> . � �� <br /> . <br /> , � . <br /> ,-� �, • <br /> . , �� <br /> r�- . <br /> r � ��-,,, � �..' <br /> � ��� �, ,'��., --J - <br /> � , <br /> p^ Postage $ PysTAL e • <br /> '� b q <br /> Certified Fee J Postm <br /> � ,� ��hC Here Z <br /> O Return Receipt Fee ,� <br /> 0 (Endorser,ient Requued) <br /> o ���o�o wu <br /> Restricted Delivery Fee , <br /> � (Endorsement Reqwred) � <br /> � $ sAs � <br /> fLl Tatal Postage&Fees <br /> O <br /> O Se�-,�---- <br /> ►� �- �a�,l �n---�'_`---------------------------------- <br /> ---------- <br /> -.------- -- <br /> � Stre � <br /> � or�� ���.. -------'-'-'--------------'----------- <br /> wa�Za�_ N �q� <br /> � ,,. <br />