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fie d <br />lc� <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 mailpiece, <br />or on the front if space permits. <br />1. Article Addressed to: <br />-�oP C: �3ax�ec <br />)h* <br />A. Signature <br />X ❑ Agent gLam ❑ Addre <br />B. eceived by (Printed. Name) C. Date of Del <br />D. Is delivery address different from item 1? ❑ Yes <br />If YES, enter delivery address below: ❑ No <br />3. Service Type <br />CorUfled Mail ❑ Express Mail <br />Registered ❑ Retum Receipt for Merch& <br />❑ Insured Mail ❑ C.O.D. <br />4. Restricted Delivery? (Extra Fee) ❑ Yes <br />2. Article Number 7012 3460 0000 6385 4339 <br />(Transfer from service labeq <br />PS Form 3811, February 2004 Domestic Return Receipt <br />gg eSflC M8tl <br />For delivery informi <br />Ln <br />Co Postage: <br />Certified Fee: <br />,, $0.48 <br />C3 Return Receipt Fee: $3,30 <br />°,r; a $2.70 <br />C3 R Total Postage 8& Fees: <br />(En $6.48 <br />Total Postage & Fees <br />M <br />rt t <br />Sent To <br />r9 Street,------------------ t n <br />C3 or P11 Box No. <br />City, State, ZIP +4 -- ------ ------ -- -------- --- - -- --- - ------ --- <br />CO <br />PS Form 3800, August 2006 See Reverse for Instructions <br />102595 -02 -1 <br />