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• Complete ite is 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: t <br />Cl on n ► ion 6f�, <br />(ooA I�mYVI�SS�o�e �S <br />) <br />V ,ck It Ste <br />bunMSDIIA co Na3G <br />X <br />Received by <br />aloe <br />s <br />❑ Agent <br />❑ Addressee <br />TC. Date of Delivery <br />different from item 1? ❑ Yes <br />pry address below: ❑ No <br />-NDWirAftiserMail ❑ 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 701,0 3090 0001 0247 5058 <br />(Transfer from service label) <br />PS Form 3811, February 2004 Domestic Return Receipt 102595-02 -M -1540 <br />(Endorsement Required) J ; ere <br />O <br />Restricted Delivery Fee NO <br />p (Endorsement Required)�J.�Q' �I V <br />l D Total Postage & Fees $ <br />cm <br />Cl e t To <br />� � <br />D - <br />Street, Apt. No.; La— <br />l� -- PO Box N.. o ;7 � r �-��-�-��-- -----�1�� <br />City Sta , ZIP +4 <br />(Domestic Mail Only; No Insurance Coverage <br />Provided) <br />For delivery information visit our website at <br />www.usps.com., <br />` -. 1 <br />(Endorsement Required) J ; ere <br />O <br />Restricted Delivery Fee NO <br />p (Endorsement Required)�J.�Q' �I V <br />l D Total Postage & Fees $ <br />cm <br />Cl e t To <br />� � <br />D - <br />Street, Apt. No.; La— <br />l� -- PO Box N.. o ;7 � r �-��-�-��-- -----�1�� <br />City Sta , ZIP +4 <br />