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SENDERi COMPLETE / •MPLETE THIS SECTION ON DELIVERY <br /> ■ Complete items 1,2,and 3.Also complete A. Signature <br /> item'4 if Restricted Delivery is desired. ❑Agent <br /> ■ Print your,name and address on the reverse Xf L ❑Addressee <br /> so that we can return the card to you. B. Re eive by(Print ) C. Date of Delivery <br /> ■ Attach this card to the back of the mailpiece, <br /> or on the front if space permits. a �� `��� C'Jr-' <br /> D. I different from item 1? ❑Yes <br /> 1. Article Addressed to: ,c� <br /> nter delivegipgo�ss below: ❑ No <br /> Jac-kstm 0vgo,,+y 1A <br /> ATr t-,l A 0�& 'tVa�io <br /> �Vt <br /> PO 0aX ��� 3. Service Ty <br /> ' `�1�\ /1 o 'bO4�o ❑Certified Mail ❑Express Mail <br /> (,V l 1 l�l> W p Registered ❑Return Receipt for Merchandise <br /> ❑ Insured Mail ❑C.O.D. <br /> 4. Restricted Delivery?(Extra Fee) ❑Yes <br /> 2. Article Number 7019 2280 0001 8255 2330 <br /> (Transfer from service label) <br /> PS Form 3811, February 2004 Domestic Return Receipt 102595-02-M-1540 <br />