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to <br />u-, (Domestic Mail Only; No Insurance Coverage Provided) <br />0 <br />m For delivery information visit our website at wwwmsps.coml) <br />L Postage: u <br />$0.45 <br />11 $2.95 <br />Fee: $2 95 <br />C3 Return Receipt Fee: $2.35 <br />o Total Postage & Fees: $5 75 -wGFti <br />Q(Enc <br />Restricted Delivery Fee <br />(Endorsement Required) p <br />� 00 <br />Total Postage & Fees <br />Sent To .......__.. _ <br />p Street, Apt 7Vo,i - "° ° <br />r or PO Box NO. •1�; �._eWJ�+CII�S -A <br />----B <br />City, State, Z /P +4 °------- ---------- ---'-' <br />■ Complete items 1, 2, and 3. Also complete A. SI ature <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. El eived <br />• Attach this card to the back of the mailpiece,` <br />or on the front if space permits. C <br />D. Is delivery addrets different from Item 1? ❑ Yep <br />If YES, enter delivery address below: ❑ No <br />yl -15 4S - 03 a <br />X�}!��% 13 Agent <br />11, '� A '' 0 Addressee <br />1. Article Addressed to: <br />a;Lo EJ,.-,,4S A-k . <br />5�-,Vn, CD V-7 S1 <br />3. Sery e Type <br />ER'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 <br />(Transfer from service label) 7 010 1060 0001 0 9 3 6 9058 <br />PS Form 3811, February 2004 Domestic Return Receipt 102595 -02 -M -1540 <br />IV��2I� <br />� fice 0 <br />i i��...esOlve� <br />V� <br />Ge� ha r� <br />MEM <br />