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SENDER: COMPLETE THIS SECTION COMPLETE THIS . . . <br /> ■ Complete items 1,2,and 3.Also complete A. Signature <br /> item 4 if Restricted Delivery is desired. r 6ti Agent <br /> ■ Print your name and address on the reverse X ❑Addressee <br /> so that we can return the card to you. B. Rec iv by(Prin(a Name) JC. Date of Delivery <br /> ■ Attach this card to the back of the mailpiece, I, J 't—)&-,5. <br /> or on the front if space permits. w <br /> D. Is delivery address different from tem 1? ❑Yes <br /> 1. Article Addressed to: If YES,enter delivery address b low: ❑No <br /> Mr. Glenn Southwick <br /> 13800 Silver Springs Road 3. Service Type <br /> Jay Em, WY 82219 Certified Mail® ❑Priority Mail Express- <br /> Registered ❑Return Receipt for Merchandise <br /> ❑ Insured Mail ❑Collect n Delivery <br /> 4. Restricted Delivery?(Extra Fee) ❑Yes <br /> 2. Article Number <br /> (transfer from service labeq 7 014 2120 0001 7869 58851 <br /> PS Form 3811,July 2013 Domestic Return Receipt <br /> QATESTOCR <br />