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R-1 <br />Amendment to Application Notices Mailed 10/19/05 <br />t <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 return the card to you. <br />^ Attach this card to the back of the mailpiece, <br />or on the front if space permits. <br />t. Article Adtlressed to: <br />LtA-f'Lfi-Ta- ~~~~y ~5 <br />airy b ~ a~~ a~~6-v <br />b (c b a- '~ 14tJ C <br />~}-u ra.~r~ b, C o g t 3o I <br />A <br />D. Is delivery address different from Rem 17 ~ Y~ <br />If YES, emer delivery address below: ^ No <br />3. Service Type ' <br />~ Certified Mal ^ Express Mali <br />^ Registered ^ Return Receipt for Merchandise <br />^ Insured Mal ^ C.O.D. <br />4. Restricted DeINery7 (Exba Fee) ^ Yes <br />2. Article Number 7003 1010 0004 2435 9661 1 <br />(rransler from servMe tans/ . <br />PS Form 3811, August 2001 Domestic Raum Receipt toasasoz-r.>•tsao~ <br />^ Complete items t, 2, and 3. Also complete <br />kern 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 ff space permits: <br />1. Article Addressee to <br />r <br /> <br />of <br />D. Is eaNery eddrms diferent from Item 1~ ~ Yea <br />M VES, emer delivery address below: ^ No <br />p.~. Box 737 <br />C.O gIi31 3. ce Type <br />' 19 n a c i . v ~ ~Certifled Mail ^ Egress Mall <br />^ Registered ^ Return Receipt fbr Merchandise <br />^ Insured Mal ^ C.O.D. <br />4. Restricted Delivery? (ExNI Fee) ~ ^ Yes <br />2. MIWe Number _ .___ __ _- _ _ _. . <br />(riansferhom seMCe le6el) I 7002 0860 0006 9268 4480 <br />PS Form 3811, August 2001 Domestc Rehm Receipt f ozsssoz-M-154C <br />