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es ~ <br />^ Complete Rems 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 badk of the mailpiece, <br />/~~o/rglo+n the front if space p/e/rJmiots. ~/J ,~ <br />r~i~~~y~~°,>,~ <br />/ ,~O/~„, <br />Go M _ z©oo -15 g <br />~ /~ /a~ <br />~' ~-~ ~ <br />.~ , Q ~ ~ <br />r <br />s ~`G <br />... <br />A Signat ~ <br />X ressee <br />B. Recelvetl by,r nted Name) C. Dat o Delivery <br />D. Is delivery add different fr~n Item 17 ^ Yes <br />If YES, ent}r slivery address below: ^ No <br /> <br />3. Service Type <br />^ Certlfietl Mall ^ Express Mail <br />^ Registered ^ Return Receipt for Merchandise <br />^ Insured Mall ^ C.O.D. <br />4. Restdcted Delivery? (Extra Fee) ^ Yes <br />z. AnicleNUmber 7004 1350 0001 1636 7527 <br />(rrans/er /rom service labeq <br />PS Form 3811, February 2004 Domestic Return Receipt tozsasm-M-isao ; <br />CERTIFIEC <br />(Domestic Mail Or <br />rl <br />Postepe S <br />a <br />o carenad FBe <br />O <br />O Rewm Redept Fee <br />(EMOrtemem RequUed) <br />~ Restricted DelNery Fee <br />~ (Endoreemem Required) <br />m <br />~ $ <br />Total Postage & Fees <br />S <br />T <br />O <br />.. rPOatomtli ,`,{ <br />/ Here <br />,( c '_ <br />;l ~ -. T. <br />i <br />