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~IR~3o5 $ <br />~~~ <br />~- <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 />Addressed to: <br />Darwin Smith <br />' PO Box 214 <br />Rockvale CO 81224-0214 ' <br />A. Signature <br />`~~~ _ .^ Agent <br />X ~T+_~----- ^ Addressee <br />B. Received by (Printed Name) C. Date of Deliv <br />~~~~~ <br />D. Is delivery address different from item 17 ^ Yes <br />If YES, enter delivery address below: ^ 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 `''~ ~-~/~~ I I Q q <br />(Transfer from service laben ~ ~~ ~ ~ 1 ~ L.JLJ l ~ ~ ` ~ ~ ~ D~ 1 <br />PS Form 3811, February 2004 Domestic Return Receipt ~ozsss-oz-M-isao <br />