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ICI Iqq I _ c-)"3� <br /> SENDER: COMPLETE THIS SECTION COMPLETE THIS DELIVERY <br /> ■ Complete items 1,2,and 3.Also complete A. Signs <br /> item 4 if Restricted Delivery is desired. �� � Agent <br /> � <br /> ■ Print your name and address on the reverse ❑Addressee <br /> so that we can return the card to you. B. Received by(Printed Name) C. Date of Delivery <br /> ■ Attach this card to the back of the mailpiece, <br /> or on the front if space permits. <br /> D. Is delivery address different from item 1? ❑Yes <br /> 1. Article Addressed to:AA If YES,enter delivery address below: ❑No <br /> �qgo Ggsk Orc-In�r� K.e, <br /> {11 t CJ Dom« 3. SServii Type <br /> C3'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 <br /> (Transfer from service label) 7012 3460 0000 6384 6938 <br /> i PS Form 3811,February 2004 Domestic Return Receipt 102595-02-M-1540 <br /> Postal <br /> CERTIFIED MAILTr,, RECEIPT <br /> m (DOMestic Mail Only;No Insurance Coverage Provided) <br /> a- <br /> CID <br /> M 3ostage: $0.69 <br /> :ertified Fee: �' i�ti 3.30 <br /> 0 3eturn Receipt Fee: , .,$ :70 <br /> RetL <br /> O (Endorser <br /> RestrictErotal Postage & Fees: 'UN 19 Z': $6.69 <br /> EZI (Endorser <br /> —0 \ <br /> -:2- Total Postage&Fees <br /> m $ ?77 USeS <br /> rU Sent To <br /> p Street,Apt.No.; <br /> ---dal �"----------- --------------- <br /> M1 or POi11� <br /> ••State,ZIP+4----• ------------ <br /> V------ ----- <br /> Ci ty, -----��------ ---------- <br /> &M't4' ww L� & C,:;)PS Form 3800,August goat <br /> 2006 See Reverse for instructions <br />