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<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 A. 'g lure D Agent <br />E A dresses <br />so that we can return the card to you. <br />¦ Attach this card to the back of the mailpiece, <br />ermits <br />ce <br />f <br />t if <br />th B. Received by (Printed Name) C. Date of Delivery <br /> <br />r - <br />. <br />p <br />ron <br />spa <br />or on <br />e different from ite <br />dd <br />li <br />D <br />I <br />d m 1? ? Yes <br /> ress <br />e <br />very a <br />. <br />s <br />1. Article Addressed to: If YES, enter delivery address below: ? No <br /> <br />` <br />G <br />l <br />?W <br />.? <br />cc) <br />balk <br />v 3. SegOde Type <br />C rOartifled Mail ? Express Mail <br />? Registered ? Return Receipt for Merchandise <br />? Insured Mail ? C.O.D. <br /> 4. Restricted Delivery? (Extra Fee) ? Yes <br />2. Article Number <br />(rransferfrom service labeq 7008 3230 <br />0002 7252 6445 <br />PS Form 3811, February 2004 Domestic Return Receipt 102595-o2-M-1540 <br /> Postal <br /> RECEIPT <br />CERTIFIED MAILTM <br />Ln (Domestic Mail only; No insurance coverage Provided) <br /> <br />..D ';ice <br />Ln <br />ru <br />r- <br />postage: <br /> <br />d Fee: $0.61 <br />$2.80 <br /> Certifie <br />r? „$2,30 <br />o Re Return Receipt <br />1 <br />O <br /> <br />E3 (Endors <br /> <br />Restric Total Postage &'Fees: 571 <br />. <br /> <br />C3 <br />M <br />rU (Endorse <br />F / H ?... •+ r <br />$ `?dyf <br />Total Postage & Fees <br />m r <br />Sent o 1- <br />T? <br /> <br />---------- <br /> Stieel, API. <br />or PO Box No. a1?15____ <br />-- <br /> <br />------------------------ <br /> 'Y' Slate, ZIP+4 p e? <br />