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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 />►. mot, CO 905D3 <br />A. Sin r <br />❑ Agent <br />❑ Addressee <br />B. Rec ed by (Printed Name) C.SB of Delivery <br />Mi z <br />D. Is delivery address different from item 1? ❑ Yes <br />If YES, enter delivery address below: ❑ No <br />3. Sece 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 7009 2820 0003 5700 8094 <br />(Transfer from service label) <br />PS Form 3811, February 2004 Domestic Return Receipt <br />102595 -02 -M -1540 <br />•1�- M 1_o7S- <br />.S _z -12 <br />- A)o c e <br />SOIP <br />DA <br />Sri. <br />i7^�c <br />