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It <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 mallpiece, <br />or on the front If space permits. <br />1. Article Addressed to: <br />C .A ti <br />1 a S1nex rranc..4- 4L 300 <br />I Mir i1;1K 1 <br />A. Signs re <br />X gent <br />❑ Addressee <br />B. Received by (Print Name) C. Date of Delivery <br />D. Is delivery address dWerent_from item 'I? ❑ Yes <br />If YES, enteydellvery address below ❑ No <br />3, Irvice Type <br />Certified Mail ❑ <br />Express Melt <br />��3 = ❑ Registered ❑ Return Receipt for Merchandise <br />❑ Insured Mail ❑ C.O.D. <br />4. Restricted Delivery? (Extra Fee) ❑ Y� <br />2. Article Number <br />(fransferfrcrr setvlce fabeg 7 013 1090 0001 4 8 3 5 0091 <br />g P$ Form 3819 , February,2004 `Domestic Retum Receipt 102595 02- M -154Q <br />k - -- — <br />r9 .. • <br />t7' <br />Lr) I� I '0 U -. <br />M <br />CD Postage $ $0.49 001 <br />-2" <br />Certified Fee $3.30 15 r-4 Postmark <br />C3 Return Receipt Fee <br />O (Endorsement Required) $2.70 Here <br />C3 Restricted Delivery Fee <br />C3 (Endorsement Required) $0.00 <br />Q' <br />C3 Total Postage & Fees $ $6.49 02/09/2015 <br />ra <br />SS p,� i� _ �:� .1<Yl <br />r or PO Box No. � la __Sher <br />.state, ziP+ ----- -- -- ---r -- <br />Aug s ,,. <br />3 <br />