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� • . . . . . <br /> ■ Complete items 1,2,and 3.Also complete A. Signatu <br /> item 4 if Restricted Delivery is desired. X ti ❑Agent <br /> ■ Print your name and address on the reverse ❑Addressee <br /> so that we can return the card to you. B, Receiv ( ted Name) C. Date of Delivery <br /> ■ Attach this card to the back of the mailpiece, <br /> or on the front if space permits. a /(� <br /> D. Is delivery address different from item 1? ❑Yes <br /> 1. Artic�e Addressed to: If YES,enter delivery address below: I�No <br /> � <br /> ��huQ �. �iE�.l�ph <br /> 'I '4(n ,A,/�/y� ( {,�.f��]Q J 3. Service Type <br /> v�r Y V IJIJV�� � ^�•,•V`� <br /> � �Certified Mail ❑Express Mail <br /> O Registered �Return Recefpt for Merchandise � <br /> �( {�(��/ y�/�n) `^�,Z O� ❑Insured Mail ❑C.O.D. _ <br /> �F-� 1��1 v �(�EJ 4. Restricted Delive <br /> ry?(Extra Fee) ❑Yes <br /> 2. Article Number <br /> (Tiansfer from service/abel) 7��2 0 510 0 0�1 6 3 0 6 0 4 3 8 , <br /> ; PS Form 3811,February 2004 Domestic Return Receipt 102595-02-M-1540 <br /> I • 1 T1 1(��1� <br /> , � �✓��l <br /> 1� - I i - <br /> � "_- <br /> m <br /> � <br /> 0 <br /> `n <br /> p Postage $ �� <br /> m /� �,/� � q� <br /> ,� Certified Fee / �y� ) � <br /> � v—• Postma � <br /> .-a Return Receipt Fee �� Here Z <br /> p (Endorsement Required) <br /> � Restricted Delivery Fee � �OOQ �' <br /> � (Endorsement Required) � V � <br /> � Total Postage&Fees � 5.�' _ ���3 �� <br /> Lll _— .._---._—-.. <br /> � Sent 70 ��� n• �,^ <br /> r ------ - - . . <br /> -----'-'-------' ------------------ ------ -�- - .. _ - ------ <br /> fU Street,Apt.No.; �1 1� ��� � <br /> O or PO Box No. ! <br /> O - - --- -------- <br /> � City,State,ZIP�-1 � ./ <br /> � <br />