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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 mallplece, <br />or on the front ff space permits. ' <br />1. Article Addressed to: <br />(~('(~£.TC.tT <br />C~D S7Gx,J ~.v~r.4N ~/ I GUC.~'f' <br />aPa ~~ <br /> <br /> <br />- <br />A 31 re <br />~ R <br />QApent <br />~I <br />X <br />V ' <br /> ^ Addressee <br />8: Rec~~jjived by (Printed Name) <br />S• tie/v~'h i~c I( _ C. at~~of DeI/Iye~j <br />~/1~/~Yv <br />D. Is delivery address tlif(l~rent from kem 1T/ ~ Ves <br />!f YES, enter de)Ivery address below: D No <br />~-~ ~ (~ ' U 4 Z as' O W f ~~ ~ 3 [] Certlfled.Mail ^ Fxpress Mell <br />I'1tG 0~ --1-~ .-" S-~ ( <br />P $ ~ <br />3z ^ Replatered <br />^ Insured Mall ^ Retum Receipt to Merchandise. <br />^ C.O.D. <br /> 4. Restricted Deflvery7 (Extra Feel ^ Yes ' <br />z. Article Number„ '' <br />(rransler lrom service Isbe~ r 1 ~ ;. 7p04 X750 0002 1464 846 <br />PS Form 3817, February 2004 , ; ~ Domestic Retum Receipt 7azsgsvz~nt-75no' <br />•• <br />.D ~ ~ <br />S <br />o .. <br />m <br />~ I'.. I ~M~ lJ.7E <br />Postage S 0.37 ~ ;~=FD`OS01 <br />Ill ~. <br />p oemaed FBB ~~ <br />j,. <br />~ Retum Redepl Fee ~y~ RO~~ ~ <br />.. ~ (Fndonament RepWred) 1.'jrJ l ~ ~ ~tqM _-~~ <br />~ Resaloted Delivery Fee <br />~ (Endoreament Raputra0) 1~q!?if'k,:;~,1Y //// <br />° total Poetege a Fees $ 4.4? \OF1~1uG(Yd/ . <br />s <br />° nt o I,, n~^r..~ T ^ ` <br />t` Sfiee{APL NO.; -'--.--Q ~`Y -..-C~....-"--- J--.L~-X .l-'""_'-" <br />arPO~~. aP~--s~.ldl~j 23oI -3:.~sa ar-f.~~~..- <br />P'fGe p r `(•~ 775`~t' l5 7 <br />:,, „ <br />