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p;' Complote items 1, 2, and 3. Also complete <br />Item 4 if Restricted Delivery is desired. <br />-IN 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 />i <br />i <br />� r � <br />If YES, enter delivery address below: <br />❑ Certifiod Mall ❑ Express Mall <br />❑ Registered ❑ Return Receipt for Morchandlso <br />❑ Insured Mail ❑ C.O.D. <br />4 Rc mm.rl Mil..., <br />—... •• • ,•••� LJ 7eS <br />Z. firlICle Number <br />(Transfer from service label) 7010 3090 0003 0 61x 4 4705 <br />- <br />PS Form 3811, February 2004 Domestic Return Receipt 102595-02-M-1540. <br />s Com, -;Oto itoms 1, 2, and 3. Also complete A. Signature <br />itetli' 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. x '" ~ `' t �� ` fes- ❑ Agent <br />w Attach this card to the back of the mailplece,-- v Addressoo <br />or on the front if space permits. B R0celved'by (pnnred Name r. <br />C. Dato of Delivory <br />I. Articlo Addressed to: <br />D. is delivery address different frorn Item 1? C1 yes <br />If YES, enter delivery address below: ❑ No <br />61-1-9 � <br />J. bervlce Type <br />❑ Certified Mall <br />❑ Registered <br />❑ Insured Mall <br />4 R <br />❑ Express Mall <br />❑ Return Receipt for Merchandise <br />❑ C.O.D. <br />---__ • estricted Delivery? (Extra Fee) <br />2. Article Number ❑ yo <br />(rrbnsterhum service label) 7010 3090 0003 0614 4699 <br />PS Form 3811. February 2004Domestic Return Receipt <br />102595-02-M-15<10 <br />