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MAC, MI9%. -105 <br />Cer i'f668 Mai I <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 mailplece, <br />or on the front if space permits. <br />1. Article Addressed to: <br />zr')s�" cz $o'la3 <br />A. <br />X <br />❑ Agent <br />B. Received by (Printed Name) &t. Date of Delivery <br />H —t <br />D. Is delivery address different from item 1? ❑ Yes <br />If YES, enter delivery address below: ❑ No <br />3. SServ�ype <br />ta'Certified Mail ❑ Express Mail <br />❑ Registered ❑ Return Receipt for Merchandise <br />❑ Insured Mail ❑ C.O.D. <br />4. Restricted Delivery? (Extra Fee) ❑ Yes <br />2. Article Number 7011 3500 0002 9607 6094 <br />(Transfer from service label) <br />PS Form 3811, February 2004 Domestic Return Receipt 702595.02 -M -1540 <br />V. (Domestic Mail C <br />O <br />N <br />� <br />r <br />Er <br />Postage: <br />$3.30 <br />,u <br />o <br />Certified Fee: 1 <br />Return Receipt Fee: <br />$21TU <br />nark <br />M <br />C3 <br />Total Postage &Fees: <br />re <br />$6.69 <br />ED <br />� <br />mTotal <br />Postage & Fees <br />rq Sent To <br />r <br />- - -- - -- <br />---------------------------------- <br />Q Street, Apf. No.; <br />r %- or PO Box No. �. E < <br />--- -- ------ s::..ZZ�l <br />City, State, ZIP +4 <br />sty CO 2 <br />PS Form 3800, August 2006 See Reverse for Instructions <br />