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^ Complete items 1, 2, and 3. Also wmplete <br />ttem 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. Artlda Addressed to: <br />~~~~ ~~~ ~'o ~/1S v~ <br />A SignaNre <br />X ^ Agent <br />^ Addressee <br />8. Receive by (Printed Ne e) C. D e of Delivery <br />rJ l- i c e L e~ <br />D. Ndelivery address dltfererrt tram ttem 7l Yes <br />IL YES, emer delNery address below: ^ No <br />~~vi'" <br />CFA.. <br />j `.''`~ <br />~~ ~. \. <br />3. Service TypB <br />^ CertHied Mail C~ Express M ': <br />^ Registered ~7,Re[um Receipt for Merchandise <br />^ Insured Mall "G.O.D. <br />4. Restricted Delivery? (Extra Feed. .- l7 Vas <br />2. ANcleNumtier 7p05 3110 0001 4708 0300 <br />(riarrsrer /rom service lat>e~ _ <br />PS Forth 3811, February 2004 <br />Domestlc Rehm Receipt <br /> <br />^ 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 iturn the card to you. <br />^ Attach this card~to the back of the mailpiece, <br />or on the front if space permits. <br />1. AQ~NCIe A//ddressed to: <br />/1 / C'G1 a~'~ ~ Sc~N/~M ~C'f$I ~O1G <br />J <br />~~, /~v cx 3~ 7 <br />~4'~`igsature <br />tozsssm-ro-tsao <br />~~ Agent <br />ressee <br />Iv d by (Printed Nam) . Da e f slivery <br />SANDL7-V~V. -`-i`N <br />D. Is dente dr,~erent.(mm it~n 71 e <br />If Y~ enter delivery addfess below: -i~No <br />n <br />`'~Y~g~ <br />3. Serv eTy~e ..., <br />^ Cert Msil, ^ F~ress Mail <br />^ Registered-= ~ -~ Retum Receipt for Merchandise <br />^ Insured Mall ^ C.O.O. <br />4. Restnctetl Deliveryt (Fxba Feel ^ Yes <br />2. Article Number <br />(rrens/er nom service iaeen 7OQ5 3110 OOQ1 4708 Q324 <br />PS Form 3811, February 2004 Domestic Retum Receipt tozsssm-m-tsao <br />