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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 />5�1 S NG��i <br />C'o vs3g <br />m �tius -lii <br />A. Signature <br />A ❑ Agent 1 <br />X (/% ❑ Addressee ll <br />B. Received by (Printr Name) Date of Delivery j <br />D. Is delivery address different from item 1? ❑ Yes i J) <br />If YES, tinter delivery address below: ❑ No �}n S qV —LStV <br />3. Servaoe Type <br />Certified Mall ❑ Express Mail <br />❑ Registered ❑ Return Receipt for Merchandlse <br />❑ Insured Mail ❑ C.O.D. <br />4. Restricted Delivery? (Extra Fee) ❑ Yes <br />2. Article Number 7010 1060 0001 0936 9287 <br />(Transfer from service label) <br />PS Form 3811, February 2004 Domestic Return Receipt <br />102595 -02 -M -1540 <br />P �t <br />