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& �V\ �' M 2b I ?-- 0 13 <br />c(f,r- + i F 1 e-6 H cki I <br />• 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 />1. Article Addressed to: <br />_ w t <br />ltvo -6 '4 CC 2"C <br />A. Signature <br />X ❑ Agent <br />El Addressee <br />Received by (P ' ted Name) C. D to glivery <br />RE/UIJf� �.1iC ( S 02 9 l <br />D. Is delivery address different from item 1? ❑ Yes <br />If YES, enter delivery address below: pAo <br />3. Service Type <br />-qcertified Mail ❑ Express Mail <br />0 Registered ❑ Return Receipt for Merchandise <br />❑ Insured Mail ❑ C.O.D. <br />4. Restricted Delivery? (Extra Fee) ❑ Yes <br />2. Article Number 7012 3460 0000 6384 8178 <br />(i°ransfer from service label) <br />PS Form 3811, February 2004 Domestic Return Receipt 102595 -02 -M -1540 <br />rO (Domestic Mail Only; <br />CID <br />� c <br />M Postage $ <br />`o $0.48 <br />C3 Postage: 30 <br />C3 R Certified Fee: �PNCE <br />0 (Endors <br />C3 Restnc Return Receipt Fee: Q <br />Q (Endors( �Vl <br />= Total F <br />-� Total Postage &Fees `> $6 <br />m <br />rn �. l <br />nj <br />r+� L) <br />-------------------- <br />� Street, Apt. No; - - - --- ------ --- - -- - -- ---t - - ----- <br />or PO Box No - 1 / H <br />1_ <br />City, State, ZlP +4 - -- ----- <br />�ev�c,r-l) co & 8 ►�? <br />