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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 mailpiece, <br />or on the front if space permits. <br />1. Article Addressed to: <br />f i r% 11; <br />A. Siah'ature <br />X j „ J,�)❑ Agent <br />�+`�'�� ddress <br />B. eived by Pdntt Name) Date of Delive <br />�l �' J AIQ 550 / -tee <br />D. Is delivery address different from item 1? ❑ Yes <br />If YES, enter delivery address below: N No <br />3. y4er P 1jiPe <br />certified Mail ❑ -1V -—Mail <br />❑ Registered Retum Receipt for Merchandi; <br />❑ Insured Mail ❑ C.O.D. <br />4. Restricted Delivery? (Extra Fee) ❑ Yes <br />2. Article Number- <br />(transfer from service label) 91 7108 2133 3939 0 0 2 9 4260 <br />PS Form 3811, February 2004 Domestic Return Receipt 102595-02 -M-1E <br />• 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 mailpiece, <br />or on the front if space permits. <br />1. Article Addressed to: <br />C— O <br />ZU <br />'�- V - ❑ Agent <br />B. Rec ived y tin Name) k C. Date of Delive <br />D. Is delivery ap(dress differer)trfrom item 1? ❑ Yes <br />If YES, enter delivery address below: ❑ No <br />3. Se ice Type <br />LS Certified Mail ❑ et Mail <br />❑ Registered V um Receipt for Marchand <br />❑ Insured Mail ❑ C.O.D. <br />4. Restricted Delivery? (Extra Fee) ❑ Yes <br />2. Article Number <br />(transfer from service label) 91 7108 2133 3939 2 9 4 4 1966 <br />PS Form 3811, February 2004 Domestic Return Receipt 102595-02 -M -' <br />