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• Complete items 1, 2, and 3. Also complete <br />item 4 it 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: J <br />MS. '( qct fir'(_) Imj�zr <br />CnSSrod5 61*9 <br />(�1)(,C/t l0✓1 cc) <br />71'5p <br />�o <br />2. Article Number <br />(Ransfer from service labef) <br />i PS Form 3811, February 2004 <br />A. Signature <br />0 Agent <br />x__ <br />0 Addressee <br />13. H. Received by (printed Name) C. Date of Delivery <br />D. Is delivery address different from it 1? <br />El Ye <br />If YES, enter delivery address below: <br />No <br />3. Service Type <br />$� Certified Mail 0 Express Mail <br />O Registered Op, Return Receipt for Merchandise <br />O insured Mall 0 C.O.D. <br />m <br />4. Restricted Delivery? (EKtra Fee) <br />0 Yes <br />7006 0100 0005 2537 9331 <br />Domestfc Return Receipt <br />10:595 -01 --15.0 1. <br />postal <br />r–i <br />CERT IFIED MAIL RECEIPT <br />m <br />m <br />m <br />m <br />D• estic Mail Only; No insurance Coverage Provided) <br />m <br />m <br />�— Ln <br />u1 <br />ru <br />N <br />Postage s <br />Ln <br />C:) <br />V1 <br />0 <br />CeNted Fee Postmark <br />O <br />0 <br />0 <br />O <br />Return Receipt Fee Here <br />(Erldarsemertt Required) <br />CO <br />C3 <br />Restricted Delivery Fee <br />--��' O <br />t3 <br />(Endorsement Requked) <br />rR <br />r-3 <br />�� - -- fl <br />Tatal Postage &Fees <br />_0 <br />o <br />..D <br />o <br />�� :;4- V- fotul /'rte <br />......_w. .� <br />f� <br />P- <br />�tV "ix !3o_r .............. <br />a x _ p -_ i -- s� r�.�. <br />_a .. 1 <br />:rr 1r <br />