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114011:1 3H10/ad013AN3 40 dOl JAI tl3)131.LS 301/1d <br /> J <br />) <br /> L SENDER: COMPLETE THIS SECTION COMPLETE THIS SECTION ON DELIVERY <br /> 0 • Complete items 1,2,and 3.Also complete A. Signature <br /> • , item 4 if Restricted Delivery is desired. X 0 Agent <br /> L ■ Print your name and address on the reverse 0 Addressee <br /> B so that we can return the card to you. B. Received by(Printed Name) C. Date of Delivery <br /> i ■ 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? 0 Yes <br /> 1. Article Addressed to: If YES,enter delivery address below: 0 No <br /> j2tn ttiefr <br /> 1 <br /> q DI NIS <br /> 4F rnp,•1 3. SeyviCe Type <br /> ``� ( 0 Certified Mail 0 Express Mail <br /> way/11101/4_ 01d <br /> ❑Registered ❑Return Receipt for Merchandise <br /> ❑ Insured Mail 0 C.O.D. <br /> 4. Restricted Delivery?(Extra Fee) 0 Yes <br /> 2. Article Number 7007 0220 0000 1989 0160 <br /> (Transfer from service label <br /> PS Form 3811,February 2004 Domestic Return Receipt 102595-02-M-1540 <br />