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m <br /> <br /> <br />~ . m `80246 . <br />m Postage s 0.37 (RrIT dD: ~ <br />m <br />~ Certified Fee 2.30 <br /> Postmark <br />~ Retum Receipt Fee 1 ~ Here <br />° (Eridmsement RequNe~ <br /> <br />° <br />° <br />Rmldcled Delivery Fee Clerk: KHZVZ4 <br /> IErWorsement ReauiRd) <br />° <br />~ <br />Tote! Postage H Fees 4.42 01/14!04 <br />N <br />D, SeatTe -j-R-I1A wAFrsc~r./ cTTJP1t¢~ wQe~ <br />~ ~' ~`B ~'43ao cueReW erc~2 s <br /> <br />N crry.ware.nps~,_,~f~t~ -.t~7iq('-~S~J <br /> <br />^ Complete items 1, 2, and 3. Also complete <br />item 4 if Restricted DelNery 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 mallpiece, <br />or on the front ff space permits. <br />1. Article Adtlrassed ro <br />TW_11'~ WM1 ~'v t"fir. <br />GUPl~L/ wQC.]a <br />X1300 4tu"R~~f Glc 'DR . S <br />~s'*N~R, CO So7J1G-153D <br />^ Sg"~~y Widener <br />X Dept of health o ~" <br />e. Received try (Printetl MameJ C. C7$;te of Delivery <br />D, Is deGVery t 7'C}'Yes <br />M YES, enter ery address Dal ~ 171No <br />JAM ~ <br />3, Service Type <br />~( Certified Mail \O Express Mail <br />^ Aeg'rstered ^ Retum Receipt for Afercha"dise <br />^ Insured Mal ^ C.O.D. <br />4. Restricted Delivery? (EUtre Fee) ^ Ves <br />2. ArticleNUmber 7001 2510 0005 5885 9413 <br />(Tiansler /rom service label) <br />PS Form 3811, August 2001 Domestic Return Receipt tozsss-of-M-2w <br />