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^ Complete items 1, 2, and 3. Also complete <br />Item 4 ff Restricted Delivery is desired. <br />^ Print your name antl 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 />w on the front if space permits. <br />1. Article Addressed to: <br />i <br />2. Article Number <br />{ (Tiansferfromservicelabel) 703 1680 0000 6423 3768 _ <br />j PS Forrn 3811, February 2004 Domestic Return Receipt tozsys-0z-M-tsao <br />Fontanari, Rudy & Ethel C. <br />331 6 E-314 Road <br />Clifton, CO 81520 <br />A Signature <br />^ Agent <br />B. Raceivetl by (Printed Name) C. Dale of Delivery <br />'4 r o1 ~artT4~d~ e%/o~ <br />D. Is delivery address different tram ttem 19 ^ Yes <br />If VES, enter delivery address below: ^ No <br />3. Serv'ce Type <br />rhfled Mail ^ Express Mall <br />isiered ^ Return Receipt for Mercfrandise <br />^ Insuretl Mail ^ C.O.D. <br />4. Restdctetl Delivery? (Exha Fee) ^ yes <br />