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a <br />■ Complete items 1, 2,--and 3. Also complete A. Signature . ■ <br />item 4 if Restricted Delivery is desired. X E3 Agent <br />■ Print your name and address on the reverse ❑Addressee <br />so that we can return the card to you. B. Received by (PrintMin <br />■ Attach this card to the back of the mailpiece, ate of Delivery <br />or on the front if space permits. <br />D. is delivery m item 1? 11 Yes <br />I If YES, ent liv dd teft below: k-, Z.No <br />S 4-0 ip 11-40 <br />3. jervice Type <br />i 7 � Certified Mail 0 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 <br />(transfer from sere 7 012 2210 0 0 0 2 2904 6141 <br />PS Form 3811, February 2004 Domestic Return Receipt 102595-02-M-1640! <br />nplete items 1, 2, and 3. Also complete A. Signature <br />m 4 if Restricted Delivery is desired. ! ❑Agent <br />•r name and address on the reverse <br />-u that we can return the card to you. Addre: <br />Attach this card to the back of the mailpiece, B Receiv by (Printed N e) C. D to of Deli <br />or on the front if space permits. <br />1. Article Addressed to: <br />X04 6 r <br />D. Is 6elivery address different from Item 1? ❑ Yes <br />If YES, enter delivery address below: ❑ No <br />3. Service Type <br />qNCertified Mail ❑ Express Mail <br />Registered ❑ Return Receipt for Merchandise <br />❑ Insured Mail ❑ C.O.D. <br />4. RestrI&PA nel. —o /c..a.., v--% <br />• ---- • -v u •EVc <br />Z. AMCIe Number <br />(Transfer from se 7012 2210 0002 2904 6134 <br />PS Form 3811, February 2004 Domestic Return Receipt <br />102595 -02 -M -1540 • <br />