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I <br />1 <br />M 1999 — C) C) —I <br />Ce 41 �1'ed M Ck I 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 />o <br />L a�i��v10 c��n�u�ee�rlr�, =iv�C. <br />140' <br />A. <br />X <br />O Agent <br />ReQO4l 6_ by (Printed Name) I C.4te g ivery <br />tin'1 ��,�11C�Y1 � i //l � <br />D. Is del*fy a4fdress different from Item 11 O Yes <br />If YES, enter delivery address below: ❑ No <br />3. Service Type <br />1Certiiled Mail O Express Mail <br />Registered ❑ Return Receipt for Merchandise <br />O Insured Mail O C.O.D. <br />4. Restricted Delivery? (Extra Fee) O Yes <br />2. Article Number 7009 2820 0003 5700 9381, 1. <br />(Transfer from service /abet) <br />PS Form 3811, February 2004 Domestic Return Receipt 102595 -02 -M -1540 <br />Postal <br />CERTIFIED MAILT. RECEIPT <br />CO verage Provided) 7 <br />(Domestic mam owy; No Insurance Co <br />rn <br />C3 $0.69 <br />, 77 <br />C3 postage: $3.30 <br />Ln Certified Fee: $2.70 <br />M Return Receipt Fee: <br />o Re $6.69 <br />C3 (Endors Total postage & Fees:", <br />O Restric $ ` ` <br />7 (Endorse wit rtequired) j <br />.'1 <br />I <br />I Total Postage & Fees <br />Sent To <br />Street, Apt. No.; � <br />or PO Box No. <br />Crty, State, ZlP +4 <br />