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R-1 <br />Additional Application Notices Mailed 10/13/05 <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 />1. Article Addressed to: <br />GI'Cy O!' ~(-ll2t~~.(CaO <br />~d-9 E. 2nd Ml~. <br />A <br />Recelvetl <br />Data <br />Agent <br />D. Is delivery address different from Item 1? ~ Ya <br />It YES, enter delivery address below: ^ Na <br />3. Se ce Type - <br />Certigetl Mail ^ Express Mail <br />^ Registeretl ^ Return Receipt for Merchandise <br />^ Insuretl Mail ^ C.O.D. <br />4. Restncted Dellvery7 /Exaa Fee) ^ Yes <br />2. ArticleNUmber 7003 1010 0004 2436 1572 <br />(fiansfer rrom seivfce <br />PS Form 3811, August 2001 Domestic Re[um Receipt 102595-02-M-i500 <br />^ Complete items 1, 2, and 3. Also complete <br />item 4 H 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. Article Addressed to <br />A Signature <br />B. Received by <br />A9~t <br />D. la delivery address digerent from ttem 1? U Yea <br />tt YES, enter delivery address below: ^ No <br />l-OIZ~r.IIX r I~ (/ <br />1a2n 4f rz~~eT iZ'~n <br />S.t~+~C~~~1.0 ~ ~ U 133 9. LvI Certlfled Mall ^.Fxpress Mall <br />^ Registered ^ Return Receipt for Merchandise <br />^ Insured Mall ^ C.O.D. <br />4. Restricted Delivery? (Exha Fee) ^ Yes <br />2. ArticleNUmber 7003 1010 0004 2436 1596 <br />(fiansler Irorrr serv/ce label) ~- <br />PS Fonn 3811,.AUgust 2001 Domestc Return Receipt toz5esaz-M~tSao <br />