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■ compl6te items 1, 2, and 3. Also complete <br />item 4 if Restricted Delivery is desired. <br />IN 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 <br />6 R" M4 <br />Guaomn <br />C <br />> 12 <br />A. <br />u ) 0 A( <br />( Printed Name) ^ C_ Dar of <br />D. Is delivery address different from item 1? I0 Yes <br />If YES, enter delivery address below: 0 No <br />3. Service Type <br />Certified Mail 0 Express Mail <br />0 Registered 0 Return Receipt for Merchandise <br />0 Insured Mail 0 C.O.D. <br />4. Restricted Delivery? (Extra Fee) 0 Yes <br />2. Article Number 7010 3090 0001 0247 5065 <br />(Transfer from service Iola 102595 -02 -M -1540 <br />PS Form 3811, February 2004 Domestic Return Receipt <br />.D <br />• Only; <br />D <br />Ln <br />For livery information visit <br />our website at www.usps.com,& <br />r- <br />GLOW G 43 <br />1 L U <br />fU <br />Postage <br />$ <br />i$ <br />0538 <br />0 <br />r-q <br />Certified Fee <br />. ,� <br />09 <br />Q <br />C3 <br />Return Receipt Fee <br />(Endorsement Required) <br />, <br />Postmark <br />1.1 Here <br />ED <br />Restricted Delivery Fee <br />(Endorsement Required) <br />r <br />Er <br />E3 <br />M <br />Total Postage & Fees <br />�. <br />�0 <br />11/27!21r12 <br />D <br />[ntTo <br />'S'treet, Apt. ao.; <br />O Box NO. <br />or PO Box No. 2 Z s.._ <br />_.�. ............�-- <br />.. — In. <br />- ..L..... <br />�t� seta• Z,P+4� � X114 <br />5 <br />PS Form :r, August 2006 <br />See Reverse for InstrUCtiOnS <br />