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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 Atldressed to: <br />A. Received by (Please Print <br />8. <br />C. (s/~{r~~ ///~ ~t r <br />ary address tlrfferelit from item 1? ^ Yes <br />enter delivery address below: ^ No <br />GEORGE ZADEL I <br />NCCI AGGREGATE DIVISION Il <br />840 EAGLE DR <br />EATON CO BO615 3. Service Type <br />Certified Mail ^ Express Mail <br />_ ^ Registered ^ Return Receipt for Merchandise <br />^ Insured Mail ^ C.O.D. <br />4. Restricted Delivery? (Extra Fee) ^ yes <br />2. Article Number (Copy from service IabeQ 7 D 01 2 51 X 0 0 0 4 214 6 0 6 5 4 <br />PS Form 3811, July 1999 Domestic Return Receipt 102595-00-M-0952 <br />s <br />uT 1 [ r r ~ <br />~G <br />O <br />~ Postage $ 7 <br />S <br />l Certified Fee /'~ <br />CJ <br />r1J Re(urn Receipt Fee <br /> (Entlorsement Required) ~ : S~Cn <br />p ResMged Delivery Fee <br />O (Endwsemenr Required) 'f~ Q~ 1~~ <br />o <br />0 <br /> <br />Total Postage 8 Fees <br /> <br />$ ~ ~ (~ J <br /> <br />3~ <br />a senr ro - <br />~ serest..... ..--.. NC~ AGG DEL~w,,,,~ <br />N ..-- -.. .. Jn <br />Apt %JO.;' REGATE:DI`$1_ONi <br />~ or PO eox rvo. 840 EAGLE DR <br />o -dryware, z~a:e'--" EATON CO BOGjs _ . <br />o T <br />'r <br />/h -a~ol - iv7 <br />~/iU/~ <br />