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r-O <br />UV'AG41C4 i301C,' I A it U ! <br />Postage $ 50.44 0181 <br />Certified Fee <br />M $2.80 04 <br />ErZStrttark <br />C3 Retum Receipt Foe Hera <br />C3 (Endorsement Required) 52.30 i . <br />C3 Restricted Delivery Fee <br />O (Endorsement Required) $0.00 <br />?l <br />rUU Total Postage s Fees $5.54 /25/ <br />y <br />Sant lb >t; , <br />1`lreet, -"e 'r <br />XwNo.; <br />N or PO Box No. SI L:.L.L._. - - •....... ?70'" ----------------------------- ...... <br />city, state, 42,51 <br />X13 o-s <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 />E Attach this card to the back of the mailpiece, <br />or on the front if space permits. <br />1. Article Addressed to: <br />L /?? 7 D%? ??1%N ?l??1?/ 71A. Signature <br />? Agent <br />X ?I ? Addressee <br />B. by ( rinted Name) C. Date of Delivery <br />D. Is delivery address different from item 1? ? Yes <br />If YES, enter delivery address below: ? No <br />3. Service Type <br />? Certified Mail ? Express Mail <br />? Registered ? Return Receipt for Merchandise <br />? Insured Mail ? C.O.D. <br />4. Restricted Delivery? (Extra Fee) ? Yes <br />z. fvrocieNUmoer 7009 2250 0003 7754 86-r6 <br />(transfer from service labeq <br />PS Form 3811, February 2004 Domestic Return Receipt 102595-02-M-1540