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OTC <br />V119 �6' 5-- -b r)-Cl <br />Ce,r- <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 />S,^ A"p <br />3oqo s .L(�•� S� . <br />CA ItiJ000l1 COJ gotto <br />J <br />A. <br />X <br />B. <br />❑ Agent <br />by (Printed Name) I C. Date of elivery <br />/d /'R /,y <br />D. Is delivery address different from item 1? ❑ Yes <br />If YES, enter delivery address below: ❑ No <br />3. Serv' ype <br />Certified Maile ❑ Priority Mail Express- <br />E3 Registered ❑ Return Receipt for Merchandise <br />❑ Insured Mail ❑ Collect on Delivery <br />4. Restricted Delivery? (Extra Fee) ❑ YPc <br />—uoae ivumoer <br />(transfer from service labeo 7 012 3460 0 0 0 0 6385 316 5 <br />PS Form 3811, July 2013 Domestic Return Receipt <br />mo <br />.o <br />M <br />CO Postage: $0.48 <br />M Certified Fee:5;j30 -7 <br />`D Return Receipt Fee: 0 <br />C3 C3 (Ends Total Postage & Fees: H $ <br />C3 Rests _ �,y , 1 <br />Q (Endorsement Requved) <br />-a <br />= Total Postage & Fees <br />M <br />fU <br />Sent To <br />�``�� <br />ri <br />Street, No -- <br />or PO Box No <br />�.7!! <br />C� <br />-�tN` /------- <br />rl — --- --- - -- <br />C1 <br />� <br />City, State, ZlP +4 <br />,.-.. j <br />- f7--- iJT <br />- <br />� Gt/ <br />PS Form " <br />