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• Complete Items 1, 2, and 3. Also complete <br />item 4 if Restricted Delivery is desired. <br />• Print your name and address on the reverse <br />so that we can return the card to you. <br />• Attach this card to the back of the maiipiece, <br />or on the front If space permits. <br />1. Article Addrp :d to: <br />c,1— )XR\'5tfED : ATN, KIM 6CRTO <br />PO rl ©X 1103 <br />aam-L-v SOZ)N6S C() <br />A. <br />0 <br />X� <br />❑ Addressee <br />B. Received by (Printed Name) I C. Date of Delivery <br />D. is delivery address different from item 1? 0 Yes <br />If YES, enter delivery address below: 0 No <br />3. Service Type <br />,Certified Mail E3 Express Mail <br />❑ Registered ❑ Return Receipt for Mercttandlse <br />❑ Insured Mail ❑ C.O.D. <br />4. Restricted Delivery? (Extra Fee) ❑ Yes <br />2. Article Number 7 013 1090 0002 212 3 4096 <br />(fransfe •from service label) <br />�S Form : $11, February 2004 Domestic Return Receipt 102595 -02 -M -1540 ; <br />(; o Py opt k'F7u0j KeCE l F7— <br />CAF PUBUc AJOTICE- M4iU�D1 'p CO, SQ)NiSs <br />