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Permit #: - - ~ ~ Confidental?: _~ <br />Class: Type- eq.: <br />From: To: <br />Doc. Name: W <br />Doc. Date (if no date stam }. <br />m Postage $2.30 f,-~ ' -•-~ <br />Certified Fee: 'l5~ rSdSl?~ ' <br />o cEOaon Refurn Receipt Fee: ~.A' /' \\C \ <br />~ Restric g Fees: p4.88~ D22 ~%~ <br />~ (E~dors Total Postage m <br />i <br />W <br />l7' <br />N TotalF W "~„ <br />r _~, t 2004 ~/ <br />~ SepI TO ~ ~ ., \ <br />LIIL \ > x'90 <br />.l-~t1 L1.~ ~O.NZ~7ic's~LZ7n--<t}~;:... _ •- - - ~ - <br />O Sr ApG/N^'o., or Po({~oxfN~o~. /~/~ ., <br />^ Cbfiplete items 1, 2, and 3. Also complete <br />' item 4 if Restricted Delivery is desired. <br />^ Print Your name and address on the reverse <br />so that we can return the card to you. <br />^ Attach this card to the back of the mailpiece, <br />or on the front if space permits. <br />1~.^`A~nrticle Ad~dre,~~ed'tlo: ~j ~/nfA •~~~ ~7 <br />rt d, ~ OX ~~7 <br />~/zoi <br />A Signature <br />$.Ap@nt <br />& Rer»lvetl by (!;tinted Name) ~ C. Date of Delivery , <br />D. Is delivery addn~s tlilferent Uom item 1 <br />Ii YES, enter delivery address belyrr! <br />\n <br />/..+~ j fl <br />1C/C~~/~ <br />3. Service Type <br />^ Cert'rfied ^ Express Mail <br />^ Registered _ ^ Return Receipt for Merchandise <br />^ Insured Mail ^ C.O.D. <br />4. Restricted Delivery? (ExGa Faa) ^ Yes <br />2. Article Number <br />rr~ars,=x,npsoY,,,~,~ ~n~o /~ 7~~ n~ni 3GS~ 1.~~/ <br />?S Form .3r.i q 1, August 2001 Domestlc Return Receipt ~ 102595-02-M-15ao <br />LL-~; <br />~ lriy <br />~ _ ~ ~ <br />