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• - zC? <br />C, �°- <br />A L/ <br />17' <br />• 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 />A. a re <br />❑ Agent <br />❑Addressee <br />B. Receiv <br />/ <br />Name) <br />8 <br />C. Date of Delivery <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 />D. Is ry add <br />I enter <br />rom item 1? 11 Yes <br />rya s below: ❑ No <br />1. Article Addressed to: <br />`tct3 C-k 3� <br />� 5 x-,> b t / `) SN0 <br />3. SeS Ice Type <br />ltl Certified Mail <br />❑ Express Mail <br />❑ Registered <br />❑ Return Receipt for Merchandise <br />❑ Insured Mail <br />❑ C.O.D. <br />4. Restricted Delivery? (Extra Fee) ❑ Yes <br />2. Article Number <br />(lFansfer from service label) <br />7010 1060 0001, 0936 7825 <br />PS Form 3811, February 2004 Domestic Return Receipt <br />102595 -02 -M -1540 <br />-w <br />/r /I'Ve- <br />