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^ Complete items 1, 2, and 3. Also complete si ~ <br />item 4 if Restricted Delivery is desired. ~,/~~~// <br />a Print your name and address on the reverse "1~ "'(" ~ <br />so that we can return the card to you. B. Received by (Printed Name) <br />^ Attach this card to the back of the mailpiece, ESC N~ P~P~ M~f//~ ~ <br />or on the front if space permits. <br />D. Is delivery address different fron <br />1. Article Addressed to: If YES, enter delivery address ~ <br />~ > v'15I~~-~ ~ ~'~~>n>~~ ~. <br />~~1,~ S~~x%~~~1rt 5~ <br />~l(m ~)~ <br />gent <br />- ^ Addressee <br />Da of elivery <br />~O / 7~4 ~ <br />i? O Yes <br />^ No <br />3. Service Type <br />Certified Mail ^ Express Mail <br />^ Registered ^ Retum Receipt for Merchandise <br />^ Insured Mail ^ C.O.D. <br />4. Restricted Delivery? (Extra Fee) ^ Yes <br />2. Article Number <br />(fransferfromservicelabel) 7004 1350 0004 3206 9389 <br />PS Form 3811, February 2004 Domestic Return Receipt <br />702595-02-M-~1~5y40 <br />° ~ 4e,R <br />~~,,:s <br />~ ~ ~ L~O~ <br />~~ <br />.<~ <br />-i <br />~~ti'~ !' ..~, <br />- k 1-t~ .. <br />