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R-1 <br />Amendment to Application Notices Mailed 10119/05 <br />^ Complete items 1, 2, and 3. Also complete <br />is desired <br />item 4 if Restricted Delive A si re ~ <br />~ ! <br />^ AgeM <br />. <br />ry X G <br />^ Print your name and address on the reverse ~ ^ Addressee <br />so that we Can return the card to you. B. Received ~ (Pooled e) C. Date of Delivery <br />^ Attach this card to the back of the mailpiece, '~ <br />~' <br />ace <br />ermits <br />ar on the tront'rf s ' <br />p <br />. <br />p A~ <br />m It <br />d tldt <br />~ 17 ^ Yes <br /> em <br />ere <br />ad <br />D. Is "7 <br />1. Article Addressed to: H Y & met deX~y add ovr. ^ No <br />~~~L,° M ~~r4-iJ o '~ <br /> J <br />rj "~C~'S 1 ,S-t• 1`I uJ y I ~7 ~ ~)~bN~~ <br /> <br />~ A'"~` <br />I d ~ b <br />~r - <br />- <br />r a. serNoe type r <br />I I ., ,~ ~ Certified Mall ^ Express Mall <br />^ Registered ^ Return Ret~ipt for Merchandise r <br />^ Insured Mail ^ C.O.D. <br />4. Resbicted Delivery? (Extra Fee) [] yea <br />2. ANcle Number ~ 71703 1010 0004 2435 9647 ii( <br />(transfer from service lebal) , ( 7 <br />_PS Form 381.1, August2001 Domestic Retum Receipt toussaz-nw+sao <br />^ Complete items 1, 2, and 3. Also complete a si nature Y ~ ` y1 4~RS <br />Item 4 ff Restricted Delivery is desired. „ -rt-Q-. em <br />^ Pdnt your name and address on the reverse ~ ~X~`'v~ n~ Addressee <br />so that we can retum the card to you. B, ~„~ by (Pdrrted ~) c. Date ry <br />^ Attach this card to the back of the mailpiece, rt~ <br />or on the frontif space permits. V <br /> <br /> <br />1. Article Addressed to: D. Is delvery address dlffereM from ttem 17 ^ es <br />rf YES, enter delivery address below: ^ No <br />V~.ITi-~ ASS B~,(L1E2 <br /> <br /> <br />uyK-F~N~ <br />W 8 I JlI/ <br />' 3. Se Type <br />~ <br /> CMlfied Mall ^ Express Mali <br /> ^ Registered ^ Retum Receipt for Merchandise <br /> ^ Insured Mai ^ C.O.D. <br /> 4. Restricted Delivery? (Extra Fee) ^ Yes 1 <br />2'~ ~~j 70Q3 1010 0004 2435 9616 <br />.PS Form 3811,,August,2001 - DomesticRetumReceipt touasaz-M-tsao~ <br />