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• 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 />7 v <br />A. Slgn re <br />X � j % )�,( C%Agent <br />❑ Addressee <br />B. Received by ( Printed Name) C. Date of DellV <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 />2. Article Number 7010 1870 0003 6945 4449 <br />(Transfer from service label) <br />PS Form 3811, February 2004 Domestic Retum Receipt 102595 -02 -M -1540 <br />