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~ Complete items t, 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 theback of the mailpiece, <br />or on the front if space permits. <br />', 1. Article Atldressetl to: <br />12a.1~h GaYn2r <br />91 a ~l Flee4v-~,~venu,~ <br />~.-ovv~rnorr~~ G' 0 805 3 <br />.. <br />~' A~ature <br />XXXX / , ~ ^ Agent <br />~U ^ Addressee <br />B. Received by (Pnnred Name) C. Date of Delivery <br />D. Is delivery atltlress different from hem 77 ~ Yes <br />It YES, enter delivery atldress below: ^ No <br />3. Service Type <br />'Certified Mail ^ Express Mtil <br />^ Registered ^ Retum Receipt for Merchandise <br />^ Insured Mail ^ C.O.D. <br />4. Restricted Deliveryl (F~tra Fee) ^ Ves <br />2. Article Number 701 1140 0002 3883 7104 <br />(Imnsfer from service label) , <br />PS Form 3811 August 2001 Domestic Return Receipt - tozsas-m-MS5o9 i <br />~ ~ ~, <br />s <br />~ ~' ~ ~ . ~. L~ ~i <br />r <br />m Posteae s <br />m <br />`~ <br />m ceruned Fee j <br />f1J Retum Receipt Fee <br />Q (FntloBement Require <br />CI R~trle[ed DeMery Fee <br />O (Fndorsamerrt Raqulre <br />Q Total Poam9a & Foea <br />S <br />ra Sent o <br />~ <br />.__ _.. . <br />Sheet, ApL No.; <br />~ <br /> <br /> <br />M1 oI PO Box No. / n r1 <br />__________________ _ L.LX _L <br />Clty, 5tffie, ZIP+ II <br />Jnw.~ <br />. I <br />_r Po~~~. <br />Rem ~' <br />A ~ <br />~~ I <br />~, <br />