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pi\Ac- M I(T�to -1 05 <br />Ce-r- �1 ��e8 M c;-1' I <br />�- <br />i <br />• Complete items 1, 2, and 3. Also complete <br />A. Signatu <br />item 4 if Restricted Delivery is desired. <br />❑ Agent <br />• Print your name and address on the reverse <br />❑ Addressee <br />so that we can return the card to you. <br />■ Attach this card to the back of the mailpiece, <br />B. Received by (Print d Name) <br />C. Date of Delivery <br />or on the front if space permits. <br />','" I / .- 6'- -_ <br />1. Article Addressed to: <br />D. Is delivery address different from Rem 1? <br />❑ Yes <br />If YES, enter delivery address below: <br />❑ No <br />?.a . 3u-'1 t <br />�., Lv QV <br />3. Se a Type <br />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 asleruom 7012 3460 0000 6385 3080 <br />(Transfer from service label) <br />t PS Form 3811, February 04 Domestic Return Receipt 102595-02-M-1 540 <br />s _- <br />(Domestic Mail C <br />u q For delivery information visit our website at www.usps.coma <br />N <br />Co <br />M Postage: $0.48 <br />Certified Fee: $3.30 <br />C3 (Er Return Receipt Fee: $2.70 k <br />C3 <br />O (EnYotal Postage & Fees: y�P� <br />Total Postage 8 Fees Q <br />M a ,�� �° <br />ru <br />Street, Apt. No.; <br />O <br />1711 or PO Box No. P� 11 <br />City State, ZIP +4 <br />QATESTOCR <br />