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S . Postal Service,,., <br />CE RTIFIED MAIL, RECEIPT <br />omestic Mail Only; No Insurance Coverage Provided) <br />Four d'-" ion visit our website at www.usps.com <br />Postage: <br />Certified Fee: <br />Return Receipt Fee: <br />Total Postage & <br />Ri <br />Restricted Delivery Fee <br />(Endorsement Required) <br />Total Postage & Fees <br />ever, -Ym'J it Stluct <br />Sent To <br />or PO Box No. , ?.a. K " b _ 1 . .....___�__ ___________ _ --- -- °-- <br />City, State, ZIPtr4 <br />SENDER: COMPLETE THIS SECTION <br />COMPLETE THIS SECTION ON DELIVERY <br />A. Si.nature <br />es <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 />1. Article Addressed to: <br />‘CL. •4. 44-;361,) <br />P. a risve 30 1 <br />14, q(10-1 <br />2. Article Number <br />(Transfer from service label) <br />PS Form 3811, February 2004 <br />$0.64 <br />$2.85 <br />' y$ `30 <br />.79 <br />Domestic Return Receipt <br />D. Is delivery address different from Item 1? <br />If YES, enter delivery address below: ❑ No <br />PO ,Scar' 3 <br />3. Serv Type <br />G3G ertifted Mail <br />❑ Registered <br />❑ Insured Mall <br />4. Restricted Delivery? (Extra Fee) <br />7009 2820 0003 5701 0899 <br />°A4-2.0O2_ !d g <br />_ 3 <br />Car ( 1 " <br />A eia 1; <br />Agent <br />❑ Addressee ' <br />C. Date of Delivery <br />I <br />❑ Express Mail <br />❑ Retum Receipt for Merchandise <br />❑ C.O.D. <br />❑ Yes <br />102595 -02 -M -1540 <br />4` <br />-1--k <br />3 bk <br />Iv <br />