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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 />A. <br />^ Agent <br />1. Article Addressetl to: //11 <br />1.ONbmonlt Shcc C6NSERVH7ioN <br />D1sTZlc7 <br />~sgs N~t,sdN ,~dAD, aax D <br />B. Received by(Prinred Name) C. Date of C <br />~itr~c:j /LJ'Z~n`~~,e e. lv~ 3 <br />D. Is deliD. Is deli ry~t firm item 1? ^ Yes <br />If YES, enter delivery atltlress below: ^ No <br /> 3. Service Type <br />I - ~nr <br />LONG/7'1oN ']'~ `Q ~~5~ 1 ~S.(Certifietl Mail ^ Express Mail <br /> ^ Registered ^ Return Receipt for Merchandise <br /> ^ Insured Mail ^ C.O.D. <br /> 4. Restricted Delivery? (Extra Feef ^ yes <br />2. Article Number 7001 1140 0~~2 3883 6985 <br />(iransler irgm service label) <br />PS Form 3811, August 2001 Domestic Return Receipt to2595-0f-M-2509 <br />~'I <br /> <br />~ ;;fi~gg pp ~e g~ g <br />~6 i ~ <br />f'rd yy ~~ ~~ww <br />L <br />y +mD <br /> . . <br />~ Poste9e s $ -T BEAR ~q~`F <br /> <br />m <br />CeNfled Fee i <br />Z ~~ <br />Rl Retum Receipt Fee N <br />(Endorsement Required) ~ y -PesOnerk ~ <br />{VRere <br />~ N N ns <br />D Restrictetl Delivery Fee p ~ <br />p (Entlorsement Requiretl) N V'7 <br />~ TMaI Postage 8 Fees ~ CJ ~ <br />-I ( ~q <br />7 <br />rR <br />.9 Sent o <br /> <br />-- LIIAIG./.11d/u?.,..Fdtf.....-.AN S.FI! Y9St4t1._~.1.3?'.. <br />~ Streef, APL No.; <br />~ or PO Bax No. <br />1lIELS <br />ctnl <br />~ <br />~ <br />C1 <br />~ <br />1~ 4 <br />flD <br />~6X <br />Z2 <br /> <br />~ <br />r` ------ --- --- ---- <br />, <br />. <br />. <br />. <br />. <br />.. <br />. <br />.. <br />.---- <br />Clty, Steta, ZlPs4 't--- <br />1.,... ~_..~ n~ onto. <br />