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• Complet9 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 />�e4n Cony &Y \[ 4lon�y <br />ou WAY5 (& BwA <br />De lA-A Co B AR-P <br />2. Article Number 7 010 <br />(transfer from service labr _ <br />PS Form 3811, February 2004 <br />i <br />D. Is delivery aaures5 � --- <br />If YES, enter delivery address below: <br />3. Service Type <br />Certified Mail ❑ Express Mail <br />0 Registered 0 Return Receipt for Merchandise <br />❑ Insured Mail 0 C.O.D. <br />4. Restricted e iivl ery? (Extra Fee) 0 Yes <br />3090 0001 0247 5072 <br />Domestic Return Receipt <br />U.S. Postal Service ., <br />CERTIFIED MAIL , RECEIPT <br />(Dom�+stic Mail Only; No Insurance Coverage Provided) <br />For delivery information visit our website at www.usps.c <br />u <br />N <br />Postage <br />nc <br />13 <br />Fee/' <br />Certified <br />Pos <br />tI <br />l� <br />Retum Receipt Fee <br />(Endorsement Required) <br />a <br />H V <br />C3 <br />�Restricted <br />Delivery Fee <br />C3 <br />(Endorsement Required) <br />Q" <br />m <br />Total Postage 8 Fees <br />0 Sent To i <br />o -------------- <br />ors -�__. <br />O Street, Apt No.; / I l l <br />r� or PO Box No. �Q �/ �_� ��-- 1 1 +j 1 ' % °° <br />V I <br />City, State, ZIP +4 <br />102595 -02 -M -1540 <br />