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^ 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 maiipiece, <br />or on the front if space permits. <br />1. Article Addressed to: <br />~~ ~ ~1~ <br />~~~ ~~ <br /><_~.~ ~(~ ~i~fn I <br />A. Sigpature ~ <br />by (P f~ NameJ ~ I C. D~fe of <br />Is delivery ad <br />If VES, enter <br />~z~~ ~ ~ .. <br />3. Service Type ,; <br />~'Certifietl Mail ~ <br />^ Express Mail <br />^ Registeretl ^ Return Receipt for Merchantlise <br />^ Insured Mail ^ C.O.D. <br />4. Restricted Delivery? (Extra Fee) ^ yys <br />2. Article Number <br />(Transfer from service to 7 0 2 2 410 ~ ~ O S 914 5 7 7 7 5 ~-~~ <br />PS Form 3811, August 2001 Domestic Return Receipt tozsss-oz-M-tsao <br /> .. _ <br />V'I ~ ~ <br />M1 <br />M1 ~. <br />~ AI <br />• s 3~S~t~~n~21~D~iver, <br /> <br />~ _ ~,. <br />.~, - <br />0 ~ <br />p Pos4ne rk <br />. <br />O <br />. RBtum Recept FSe <br />(F_ndoreemern Repulred) _ .- _ t'~, <br />. ~ Restrkled DeMery Fee <br />. <br />/ 'S,'•'• <br />\ <br />, 7 (F1MOreemenr ReWbeE) ~ ~Q~ J <br />• <br /> TMaI Poateae 6 Fees ,( ~. ~J <br />$ % ' -I ~ ~ q <br />b~ <br />~ : p <br />~ i <br /> <br /> <br />