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Complete kerns 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 nrtum the card to you. <br />1 Attach this card to the back of the mailpiece, <br />01 OR thB flOrlt ff BpaCB perm713. <br />. Ante Addressed to: <br />/nei/~ ~Zhc/,Cyrr~t ~'/aoao%S <br />goy l3acGt a v ?J~ <br />/'-1~ ~1Glr~CRn~QG'ary <br />o ~60 / <br />~. Amble Number <br />. (Renate. fNrn s <br />'S Forrn 3811, <br />A Signature <br />^ Agent <br />~~N s Addle <br />e. ReceNed by ( ~ led Name) C. Date/~o~f tpeJ1 <br />`i'JT l <br />D. b delivery eddresa different Inxrr ftem 11 L7 Yee <br />a YES, errter dalNery adtlresa bebw. ^ NO <br />3. Type <br />NrtifPed Mafl ^ Exprem Mali <br />Registered O Re[um Receipt for Merchantlise <br />^ Insured Mall ^ C.O.D. <br />4. Restricted Deliveryl(Extra Fee) ^ Yes <br />7003 [1500 0~~1 9355 6248 <br />February 2004 Domestic Return Receipt <br />1025sso2-M-15na <br />