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Permit #: b Confidental?: <br />Class Type-Seq.: l1 0.3 <br />From: To: <br />Doc. Name: <br />Doc. Date (if no date stamp): // e <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 mailpiece, <br />or on the front it space permits. <br />1. Article Adtlressed to: <br />~~Ua~ <br />Ua•/t~a ~av,~, <br />~rao ~~ s <br />~~.~~u~r,CV go~l~ <br />2. Paticle Number (Copy from service <br />A. Receivetl by (Pied PnntrCl rfy) B. Da~ Deli <br />J <br />D. dr tld dit tiro Y 1~ ^Yes <br />!/ i ~ G"i <br />C. Signa <br />X ^ Agent <br />^ Addre <br />s e rvery a ress i eren m i em <br />If YES, enter delivery atldress below: ^ No <br />3. Service Type <br />~ertified Mail ^ Express Mail <br />^ Registeretl ^ Return Receipt for Merchandise <br />^ Insuretl Mail ^ C.O.D. <br />4. Restrictetl Delivery4 (Extra Fee) ^ yes <br />PS Fonn 3811, July 1999 Domestic Return Receipt <br />S <br />O <br />0 <br />m <br />m <br />f`- <br />N <br />.Y <br />O <br />O <br />O <br />O <br />,-R <br />~r7 <br />ti <br />a <br />O <br />O <br />N <br />llMti•1313 Sherman, t?m. 215, Dancer, Ctl an~na <br />Postage $ <br />Certified Fee <br />Rehm Receipt Pea <br />(Endorsement Required) <br />Restricted neGVery Fea <br />IEndorsement Required) <br />Total Postage 8 Fe9s <br />Box No. <br />~ .--- -, <br />-~. <br />/cdSfPOStmark <br />r ~,, <br />n s\ <br />' ~~, 2N- <br />t-F ~:~,~_ 203 ti <br />.~ <br />,~ ~..~ aX~ - -- <br />102595-W-M-e952 <br />