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ENDER: COMPLETE THIS SECTION <br />1 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 retum the card to you. <br />1 Attach this card to the back of the mailpiece, <br />or on the front if space permits. <br />1. Article Addressed to: <br />6 - L � t f 4 L e il e3e.>r1 <br />l l 7 h ervnuvi . <br />Siztie 30 <br />'.. Article Number 7 0 0 7 14 9 0000 5 419 0281 <br />(Transfer from service label <br />'S Form 3811, February 2004 Domestic Return Receipt <br />U�o <br />. (Rat = "etl <br />q <br />r <br />n <br />3 <br />3 <br />3 <br />3 <br />3 <br />Postage <br />Certified Fe <br />Return Receipt Fee <br />(Endorsement Required) <br />Restricted Delivery Fee <br />(Endorsement Required) <br />Total Postage & Fees <br />Sent T4 <br />._ -. <br />-817i6-1,-A791: Na; ii . <br />% u t / . 7 7 < i� ' -' " ,�,r ia- 5 T ^ . 3 0o ..1 <br />or PO Box No. <br />A. Signateue <br />X <br />COMPLETE THIS SECTION ON DELIVERY <br />CI Agent <br />❑ Addressee <br />Date of Delivery <br />D. Is delivery address different from m 1? ❑ Yes <br />If YES, enter delivery address below: ❑ No <br />3. Service Type <br />,erttfed Mail 0,E_Express Mall <br />O Registered '❑ Receipt fe-A tlise <br />❑ Insured Mail C.O.D. <br />4. Restricted Delivery? Pita Fee) 0 Yes <br />Return Receipt.F (Endorsement Required) <br />) <br />D <br />(Endorsement Restricted Recurred) <br />Total Postage & Fees <br />102595.02- M-1540 <br />Certified Fee <br />Sena Fo / ` L). 1'1 st e 1'l 4.,:a, L -7 _. <br />_ ' _ cam_ . . a 31, ? 1 <br />