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• 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: Y <br />XCP--t <br />/{ 114K�aPa <br />X5401 <br />2. Article Number <br />(Transfer from service label) <br />A. Sig ture <br />0 Agent <br />X v 0 Addressee <br />B. by nted Name) DEC G. Dat?M felivery <br />D. Is delivery address different from item 1? 0 Yes <br />If YES, enter delivery address below: 0 No <br />3, Service Type <br />0 Certified Maile 0 Priority Mail Express- <br />0 Registered 0 Return Receipt for Merchandise <br />0 Insured Mail 0 Collect on Delivery <br />4. Restricted Delivery? (Extra Fee) <br />?012 3460 0002 11 ?3 19 ?0 <br />PS Form 3811, July 2013 Domestic Return Receipt <br />4j (Domestic Mall C <br />D- <br />Iq <br />M <br />Postage $e <br />fl.l Q v4dCertitied Fee <br />Return Receipt Fee Postmark, <br />C3 (Endorsement Required) Here <br />0 C.+ � <br />Restricted Delivery e <br />C3 (ErdorsemeMRequir ed) E C 2 2 20M <br />...D t <br />f <br />Total Postage &Fees <br />m _ <br />rU <br />Sent To•' f <br />-3 <br />I7- <br />Stree Api No.; C <br />or PO Box No. f �, " <br />--------------- .............. ................. ...... <br />C 4y State. 27P +4 <br />All A A eb" A' l S <br />0 Yes <br />