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~- <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 if space permits. <br />1. Article Add~jessed W: r <br />©1,~.~ 1:07t59iYl)ft~lbti'~ <br />~s ~s i~-~-4-X (~l a,3 ~ ~a <br />jso ~~.rd w,h <br />tcJotxl(c~d ~ go~G 3 <br />b R ed by (Please Print CleaAy) ~ B. Date of Delivery <br />u.rc C ~'G•V7ryl ~ - 8-2 <br />C. Sig~na/t~ure <br />~n', .. fin.. <br />X ya <br />A <br />lN <br />~ <br />` <br />~ ~ <br />^ Agent <br />. <br />. <br />. <br />i <br />O~ / <br />~~ ~ ^ Addn:ssae <br />D. Is delivery address tlilferedt fiom item 1? ^ Yes <br />H YES, enter delivery atltlress below: ^ No <br />3. Service Type <br />^ CertRed Mail ^ Express Mail <br />^ Registered ^ ReWm Receipt for Merchandise <br />^ Insured Mail ^ C.O.D. <br />d. Restricted Delivery? (Erfra Feel ^ yes <br />~; 7001 1940 0004 6882 192U <br />PS Form 3811, July.1999 Domestic Ra[urn Receipt 102595-0aM-0952 <br />I <br />~ 0.74 IRIIT ID: 0609 <br />f1J Pastaga j <br />~ Z.10 <br />~ Cercrflad Fee <br />'~ <br />Relum Receipt Fee 1.50 <br />PosMark <br />S (F~dorsemen[Raquired) RIXe <br />o Clerk; K6F471 <br />~ Restricted OelWery Fae <br />(Endorsement Required) <br />pq/ <br />~ Total Posnge 6 Feea .~ 7'~ P S <br />O <br />~ ent o O <br />j <br />o <br /> Sfrce4 APf• No.; tt~ <br />~j <br />l <br />7 C <br />' <br />0 <br />ra ar PO Box No. <br />__......_...._ ...... . <br />`~ <br />.........l~~f <br />.__ 6 <br />~. __.___.._...____ <br />p LItY, Stale, ZIPS 4 `~~ <br />M1 <br />