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^ Complete kerns 1, 2, and 3. Also complete <br />kern 4 H Restricted De1Nery is desired. <br />^ PrIM 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 maUpiece, <br />or on the front H space permks. _ <br />t. ANcle Addressed to: <br />p~ if , co ~/~~; <br />a <br />X <br /> <br />O bent <br />D. Is deGvay address dmerent 4o{n Item 71 V Yes <br />k YES, enter delhrery address below: ^ No <br />~3. Service Type <br />GY~dlfled PAaO ^ F~ress tAeO ...r- <br />^ Rem l7 Return Receipt t« Merdmndba <br />a. Reanlctad Da~nrertr+ ta<.ros reel ^ ras <br />z. ~lat+°mher 7005 1820 0~~8 X817 0193 <br />(Hensler from seMOe kbe0 <br />PS Form 3811, February 2004 Domestic Rewm Receipt i^"^` "" "ism <br />U.S. Postal Servicen. <br />CERTIFIED MAILrn, RECEIPT <br />(Domestic Mail Only; No Insurance Coverage Provided) <br />r <br /> ~ ~ ~ ~ <br />~ <br />~ W BI!it1KL' ~.'S ~' ~3' L--3 <br /> <br />°' Pos'eae s 50.34 <br />dS'rl <br />r,. , <br />r <br />o CeNeed Fee 52.40 ~r7 <br />~ <br />~ Hetem gecelpt Fee <br />(Endorsemem Requ'ump <br />51.8°r <br />~... <br /> R <br />~ <br />~ <br />~ <br />e <br />a (E <br />rM <br />oree <br />mem <br />RpWr <br />tl <br />50.00 <br /> <br /> Total Postage a Fees $ SL_!,L r91H~7 u,1 <br />.D -•"~~...~ <br />a sea` ° _.D,~I~A .S;;r~e~.!/i.~~•1".--_-_---- -- <br />R 3ffeef, ilFK Aroi._.._....t_....- '-----J- yl~ --..___... <br />orao eoxNO. I/11-'1'.~---._{..y?cv .1"4~ <br />/1/!4, r~rrr, GO <br />:, „ <br />