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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 />L,•.rcl,�.�i , � � 0 5 � � <br />A. Sig lure <br />❑ Agent <br />r� ,, <br />X� 1/�`G' V� — <br />❑ Addressee <br />B. Received by (Printed Name) <br />C. Date of Delivery <br />D. Is delivery address different from item 1? <br />If YES, tinter delivery address below: <br />❑ Yes <br />❑ No <br />3. Se ce 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 7 010 1060 0001 0 9 3 6 9119 <br />(Transfer from service label) <br />PS Form 3811, February 2004 Domestic Return Receipt <br />102585 -02 -M -1540 <br />Sis¢ z. <br />0 <br />