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■ Complete items 1, 2, and 3. Afro 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 maliplece, <br />or on the front If space permits. <br />1. Article Addressed to. <br />-V, <br />A. Signature <br />x j_ o Agent <br />Addre <br />a. ecOml by (Printed name) C. Doe of Im <br />% / <br />D. Is delivery address merent fr m Item 1? 0 Yes <br />If YES, enter delivery address below. O No <br />3. Service Type <br />D Certified Mail O Express Mall <br />O Registered O Return Receipt for Merdwndise <br />O Ina med Mail O C.O.D. <br />4. Restricted Delivery? (Extra Fee) O Yes <br />z. (ram Number <br />7011 2970 0002 4120 9681 <br />(Transfer from service lab <br />! PS Form 3811, February 2004 Domestic Return Receipt 102595- 02 -WI540 <br />