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^ Complete items i, 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 Addressed to: <br />~f~ll~ <br />B. ~ceivetl by (Pdnted Name) C. Date of Delivery <br />1'T)a~ n~ ~ Nd, ~~ 18/~~ <br />D. Is delivery address different m Rem 11 ^ Yes <br />It YES, enter delivery adtlress below: ~No <br />Mr Mason King z.~ \ I - <br />6455 County Road XX 3. service Type <br />Box 68 ~ ^ Certifietl Mail ^ Express Mail <br />Cope CO 80812 ^ Registered ^ Return Receipt for Men;handlse . <br />^ Insured Mail ^ C.O.D. <br />4. Restdcted Delivery? (Extra Fee) ^ Yes <br />z. Article Number 7005 3110 0000 2197 8570 <br />(Transfer Irom service lebeQ <br />PS Forth 3811, February 2004 Domestic Return Receipt 102595-02-M-1540 <br />~J <br />~~~~;ed,~{Q;~ ~ec~y <br />~„t. 11~2~Uw <br />