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^ Complete items 1, 2, and 3. Also complete <br />item 4 it Restricted Delivery is desired. <br />^ Print your name and address on [he 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 Atldressetl to: <br />r r-\t _ <br />~ L L Ct c ` ~) L~.1~) C ~ U-L ) t-r~ <br />•~ liC - 1 <br />~~: , p . ~~~~ 3 ~f S- <br />2. Article Number (Copy /rom service label) <br />A. Received by (Please Pdnt Clearly) .Date of Delive. <br />`r <br />C. S g u <br />en <br />^ A rassee <br />. Is d address d from item 77 Yes <br />YE enter delivery address below: ^ No <br />3. ice Type j. <br />Certi(ed Mail ^ Express Mail <br />^ egisteretl ^ Retum Receipt for Merchantllse l: <br />^ Insured Mail ^ C.O.D. !' <br />4. Restricted Delivery? (Extra Fee) ^ Ves <br />ri <br />PS Form 3811; July 1999 Domestlc Return Receipt <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br />r <br />~ Sent To ~. ~ <br /> <br />p <br />^ Street. Apt. No.;. r Po Box No <br />~I ~ <br />3 <br /> ' <br />' " <br />V'~--- <br />O <br />r \ <br />City. Stzie, Z1~r4 (r r l <br />' <br />' / ~ ` Z <br />J <br /> 1 . ~ v , <br />w <br />_l to 1. ~ <br />:rr rrr <br />102595.00-M-0952 <br />t~ <br />S <br />S <br />N <br />^J '~ :1 <br />~ Postage $ / ~ .~ i' :4 S <br />j` /^/ '..s <br />N Certifietl Fee (..J I<- 'i"~~ N <br />rtJ 1 ~ 1 Postmark <br />Return Receipt Fee ~ ''ire <br />S (Entlorsement Requiretl) I ~-~ ~ j <br />b ~.~~~ ,, <br />O Restrictetl delivery Fee _ .. <br />O lEntlorsement Requlredl -~ J ~ <br />~ Total Postage 8 Fees $ • '-- <br />