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• Complete items 1, 2, and 3. Also complete A. <br />Rem 4 if Restricted Delivery Is desired. X <br />• Print your name and address on the reverse <br />so that we can return the card to you. R( <br />■Attach this card to the back of the mailpiece, <br />J <br />or on the front if space permits. <br />D. Is delivery address different from <br />1. Article Addressed to: If YES, enter delivery address b <br />1 <br />by ( Printer{ NJme) I C. <br />1? <br />❑ No <br />V O I <br />.,M- 19 ?Z- 10 Z <br />• /yjV- ,?jq /l X 39 <br />/V, <br />3. Service Type <br />n 1 l' <br />eV <br />, (_' <br />❑ Certifled Mail <br />❑Registered <br />❑ Express Mail <br />❑ Return Receipt for Merchandise <br />Wo <br />�(u <br />I <br />El Insured Mail <br />❑ C.O.D. <br />M <br />,. <br />$0.45 <br />7009 2820 <br />postage <br />Fee: <br />$2.95 <br />$2.35 <br />r� <br />"' <br />Certified <br />Return Receipt Fee: <br />Receipt <br />102595 -02 -M -1540 <br />$5.75 <br />M <br />o <br />Total postage &Fees: <br />(tndo- -i� rn Heyuired) <br />ru <br />CO <br />Total Postage & Fees <br />t <br />1 .Y <br />rLi <br />Er <br />O <br />Sent TO <br />4 - <br />- tre <br />r <br />O <br />or PO Box No. <br />• Complete items 1, 2, and 3. Also complete A. <br />Rem 4 if Restricted Delivery Is desired. X <br />• Print your name and address on the reverse <br />so that we can return the card to you. R( <br />■Attach this card to the back of the mailpiece, <br />J <br />or on the front if space permits. <br />D. Is delivery address different from <br />1. Article Addressed to: If YES, enter delivery address b <br />1 <br />by ( Printer{ NJme) I C. <br />1? <br />❑ No <br />V O I <br />.,M- 19 ?Z- 10 Z <br />• /yjV- ,?jq /l X 39 <br />/V, <br />3. Service Type <br />n 1 l' <br />eV <br />, (_' <br />❑ Certifled Mail <br />❑Registered <br />❑ Express Mail <br />❑ Return Receipt for Merchandise <br />� <br />�(u <br />I <br />El Insured Mail <br />❑ C.O.D. <br />4. Restricted Delivery? (Extra Fee) ❑ Yes <br />2. Article Number <br />(transfer from service label) <br />7009 2820 <br />0003 5701 <br />3784 <br />PS Form 3811, February 2004 <br />Domestic Return <br />Receipt <br />102595 -02 -M -1540 <br />A/, <br />ID It 1)KMs <br />� rft, <br />