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CC, l � i ecS M Co" I <br />V Complete 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 />Article Addressed to: <br />�ti1`i1 �Crrnl�a�r? <br />c;o� N l,l�u1 Ave . <br />)VIW ad (o $10' <br />A. Signature <br />X <br />P, (( eived y (Printed Name) C. D to of Delivery <br />In �t�=r � 4o,, i/ q <br />D. Is delivery address different from item 1? ❑ Yes <br />If YES, enter delivery address below: ErNo <br />3. Service Type <br />rUfled Mail ❑ 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 7 012 3460 0 0 0 0 6384 8116 <br />(IPansfer from service labeq <br />PS Form 3811, February 2004 Domestic Return Receipt <br />102595- 02•M -1540 <br />rq <br />(Domestic <br />CIO ,•'f: STQ.~,. <br />•$0.69 <br />SPostage: <br />$3,30 <br />Certified Fee: <br />$2.70 <br />EG Return Receipt Fee: <br />stmark <br />C3 <br />o <br />Total Postage & Fees: - <br />iere <br />J $6.69 <br />C3 <br />.D <br />= Total Postage & Fees <br />1 $ <br />M <br />a <br />Sent To <br />�I Y')"C�A1 <br />Ia�AJUw�;ti� �duR+4 r <br />r3 <br />- - - - ----- - - - - -- ----------------------------------------- <br />Street, Apt. Nq.; - �j <br />or PO Box No. c�C)V© A, L,vihN• <br />D <br />Ave , <br />r" <br />---- ---------- ---------- ---- -------- °------------- --------- -- ----------- - ---- -- <br />City State, ZIP +4 co o <br />PS Form :,, August 2006 See Reverse <br />