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r Complete items 1, 2, and 3. Also complete <br />item 4 if Restricted Delivery is desired. <br />0 Print your name and address on the reverse <br />so that we can return the card to you. <br />O Attach this card to the back of the mailpiece, <br />or on the front if space permits. <br />Ad <br />• <br />ciao 3 1F - CLICO,UM 6-1 <br />L:) lilac 6, <br />ice Type <br />Certified Mail <br />o Registered <br />0 Insured Mail <br />7009 2820 0004 <br />Logtoggv <br />A. Signature 0. Agent <br />• 0 Address. <br />B. Received by ( Printed Name) C. Date of Delive <br />V) /till <br />D. Is delivery address different from item 1? 0 Yes <br />If YES, enter delivery address below: 0 No <br />• <br />• <br />i t, ki <br />. , r o l <br />WV'ei <br />4. Restricted Deliveir (Extra Fse) <br />0 Express Mail <br />0 Return Receipt or Merohandt <br />0 C.O.D. <br />3268 0733 <br />0 YTe, <br />2. Article Number <br />alansfer from service labal) <br />- ----- <br />PS Form 3811v .February 2004 Domestic Return Receipt 102595-02-M-1E <br />