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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 mailplece, <br />or on the front if space permits. <br />Article Addressed to: — <br />Po fox" S-o? <br />G� VA-ZT10) co <br />A. Signature <br />❑ Agent <br />X 0 Addressee <br />B. Received by (Printed Name) C. Date of Delivery <br />D. Is delivery address different from Rem 17 ❑ Yes <br />if YES, enter delivery address below: ❑ No <br />3. Service Type <br />A Cerined Mall ❑ Express Mail <br />❑ Registered R Return Receipt for Merchandise <br />0 insured Mali 0 C.O.D. <br />4. Restricted Delivery? (Extra Fee) ❑ Yes <br />2. Article Number 7006 0100 0005 2537 9348 <br />(rransfer from service ?abeq <br />PS Form 3B11, February 2004 Domestic Return Receipt 1o2595-02-M -1540 <br />Postal <br />�- c0 <br />CERTIFIED MAIL,, RECEIPT <br />ce <br />coverage Provided) <br />m <br />m <br />�- <br />_ ___-- -- rn <br />to <br />—_--- ry <br />IU <br />Pmstuga s <br />—_ <br />-- ---- -- O <br />-- <br />in <br />O <br />Cort tied Fee <br />POSUT rk <br />_--- <br />C3 <br />co <br />G <br />a <br />Return Receipt Fee <br />SEndocsonsefct Reeuhed) <br />Hcrc <br />Co <br />O <br />G <br />G <br />ResWed DaAvery Fee <br />iEndWsemcrri Rcgwred} <br />---- -� G <br />G <br />lo;sl postetra & Fees <br />O <br />O <br />O <br />Sorg r � <br />�" ` . "" ................. <br />[� <br />r <br />SrreDr. ApL na.; <br />or PO BOX No. <br />Crt;; SYatn, ZfP+'t /' (� <br />,.- <br />1 im <br />: i 11 QI <br />