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CID <br />(Domestic <br />Ln <br />. <br />FORT Ih C $ 51 N' <br />' <br />ra <br />ru <br />C3 <br />Postage <br />$ $0.70 <br />10 \N S •� ' M1 <br />0 <br />fU <br />Certified Fee <br />$��� <br />t� Postmark S <br />M <br />0 <br />Return Receipt Fee <br />(Endorsement Required) <br />$2.70 <br />Her \4 tj <br />— ` �i <br />O <br />Restricted Delivery Fee <br />(Endorsement Required) <br />$0.00 <br />CC <br />C: 1, <br />0 <br />J <br />r� <br />ri <br />Total Postage & Fees <br />1 $ $6,7 <br />O <br />Sent o <br />/� <br />I .' <br />J si, <br />A:y------ - - - - -- <br />,-=I <br />Sfreef,Apt No, <br />____.______ _ t7 ___.......__ n ij�.} <br />or PO Box NO •p Lys - b c. �Fi.. <br />City, State, ZIP +4 <br />0s' r <br />• Complete Items 1, 2, and 3. Aiso 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 Addressed to: <br />A. Signature <br />-'❑ Agent <br />X 2,,ib�. - 0 Addre <br />B. Qegpiviied lyyy (Printed Name) 9 Date o <br />j Del <br />D. Is delivery address different from Item 11 0 Yes <br />If YES, enter delivery address below: 0 No <br />3. service Type <br />0 Certified Mail 0 Express Mail <br />0 Registered 0 Return Receipt for Merchandise <br />0 Insured Mall 0 C.O.D. <br />4. Restricted Delivery? (Extra Fee) 0 Yes <br />2. Article Number 7 011 0110 0002 10 21 8548 <br />mansfer Irvin service IaW <br />PS Form 3811, February 2004 Domestic Return Receipt 102595 -02 -M -1540 <br />