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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. JArticlePddressed to: <br />e <br />SC�U�>Mla�, TLJ <br />A S�Qat�re. , <br />,�,7SA/Wft ❑Agent <br />X ❑ Addressee <br />B. J <br />W" I (6�I,d Name) C. D�je of Delivery <br />J. <br />D. Is delivery address different from Item 1? ❑ Yes <br />If YES, enter delivery address below: ❑ No <br />3. Service 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 5701, 3975 <br />(transfer from service label) <br />PS Form 3811, February 2004 Domestic Return Receipt 102595 -02 -M -1540 <br />•N1 - to Z <br />;� DOLS <br />'��qrA <br />