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^ Complete Items 1, 2, and 3. Also complete A~ <br />item 4 if Restricted Delivery l9 desired. <br />^ Print your name and address on the reverse <br />so that we can return the card to you, S, <br />^ Attach this card to the back of the mallplece, <br />or on the font If space permits. <br />1. Article Addressed to: ~ D <br />I vov~ 1~ e l~, Chav~~ bets <br />X28 5 S~ i-twy~yh <br />I`ll~e 1 CCU O~~ J~ <br />Agent <br />by (Printed Name) C. DJp~to °°~~ De''YYvery <br />ban 1~e r'-s /n l i~ 1151 <br />le delivery eddres@ different from Hem 1?' u res <br />If YES, enter delivery adtlresa Debw: ^ No <br />s. servrce rypa <br />^.Certifled Mall d Express Mau <br />CI Registered ^ Return Receipt for Mercfmndise <br />O Insured Mall ^ C.O.D. <br />4. Aestdcted Delivery? (Firm Fee) .^ Yes <br />2.~ ANcle Number <br />(7/ansfer lrom seMr 703 311 005 1084 3572 <br />PS Form $811, August 2001 Domestic Return Receipt tozsas•oz-M•tttao <br />^ Compfete {tams 1; 2, and 3, Atso complete <br />item,4 If Restricted Delivery is desired. <br />^ Print your name and addresg 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 />1. Article Addressed to <br />a <br />ecei ed by (P~(r t~b N~meJ (D.' Data of palivery <br />n~Ew rl , F~''lJY1P t v ~1~,2.t~11 ~f <br />D, Is deWery address different fmm ham 1? ^ Yes <br />If YES, enter tlellvery address below: ^ No <br />' S1-cz~-e. o~ Calora~~ <br />~2 01 L . ~ r ~,an sas f~e, <br />3. Service Type <br />`~~, V ~ (1 r-~ O ~ q ~ ~ _ 2-(l O ^ Certltled W1eIl ^ Express Mall <br />U I l~V o G ~1 l ^ Reglaterad ^ Return Recalpt for Memhandlse <br />^ Insured Mall ^ C.O.D. <br />4. Restdcted Delivery? (Firm Fee) ^ Yes <br />2. ArticleNUmber : 7003 3110 ~0~5 184 3626 <br />(Transfer lrom,ser <br />PS Farm 3811, August 2001 Domestic Return Recalpt to2sas-0z-M•isab <br />~ . .. <br />yr 4 <br />NI -.~~~~ - a~S <br />.' ~;- /V D 1 r GC..S FOR Pl /~ - C~ Z <br />~iv F <br />