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• Complete items 1, 2, and 3. Also corrrplete <br />item 4 if Restricted Deify is desired' <br />■ Print your name and address on tha <br />so that we can Tatum the card to you. <br />• Attach this card to the back of the mallplace, <br />or on the front if space Peff( <br />1. ArWe Addremed t0. <br />X <br />Ayr L ® 0 A90ft <br />C. Deis of Delivery <br />lo-dehvery aaomm d from imm 1? U/WW <br />if YES. order deihrerY address below: <br />N . <br />N <br />Lonnie L Gerber <br />1601 Sundown Dr. <br />Colorado Springs CO 80906 s. NrtlOedman 6�for . <br />0 Reid <br />4. pm&iated Wlvwp FDMv Fee) 0 Yes <br />2. Ar"Nurr*er ` 7007 2560 0000 3980 6447 <br />mwjsIijr from service kkw <br />DonresNc Ream f;soeipR <br />Ps Form 3811. February 2004 — <br />Postal <br />CERTIFIED IVIAIL,, RECEIPT <br />r"' (Domestic Mail Only: No Insurance Coverage - Provided) <br />c 1 <br />Ir P~ S $0.46" <br />m <br />Cad Fes $3.10 03 Paean <br />O <br />O (Endorsema►r �� $2.55 hr.re <br />Fee <br />O ( rear $0.00 <br />Ln Tom! Postese & Fen $ $6.11 06!18/2013 <br />rU nn, <br />° �0�.�` <br />