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^ Complete Rems 1, 2, and 3. Also complete <br />Item 4 if ResVicted Delivery is tleslred. <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 mailplece, <br />or on the front K space permits. <br />1. Article Addressed to: <br />due. ~- C~~van ~~ernen~ <br />0. ~X ~ <br />nne,1,~`e.1~S,CO ~ogt~ <br />a sa :ere <br />X ~, <br />B. Reoe(ved <br />D. <br />C. <br />^ Agent <br />fiom Rem 77 ^ Yes <br />ass below: ^ No <br />~I ~,~~ ~6200I <br />3{S'BrvICB TypB.' <br />~Ceitlfied:Mall~ Express Mail <br />^ Registered ^ Retum Receipt for Merchandise <br />D Insured Mall O C.O.D. <br />4. Restrkted Deliveryl (Extra Fee) ^ Yes <br />2. Article Number 7p04 289 ~~03 8654 0668 <br />(lJartsfer from servke kr.e" <br />PS Form 3811, February 2004 Domestic Retum Receipt tozsssoz-M-tsao <br />