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~L°~ <br />From: <br />Doc. Name: / <br />Doc. Date {if no date <br />^ Complete items 1, 2, and 3. Also complete A. azure <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.. B Receives <br />^ Attach this card to the back of the mailpieCe, . <br />or on the front if space permits. <br />L~A/rt/~icl~e Add~ressjetl to: <br />81ao ~~- <br />~~.~, ~o ~n~ ~~ <br />C. <br />^ Agent <br />Is deNvery address tlifferent from item 17 ^ Yes <br />If YES, enter tlelivery atltlress below: ^ No <br />3. Service Type <br />~Cert~etl Maii ^ 6tpress Mail <br />^ Registered ^ Retum Receipt for Merchandise <br />4. Restricted Delivery? (Extra Feel ^ Y~ <br />2, Article Number <br />(Transfer7rom service /ad 7002 241D 0005.9145 7792 <br />PS Form 3$11, August 2001 Domestic Return Receipt tozsaso2-Masao <br />CERTIFhED MAILrM RECEIF <br />(Domestic Mail Only; No Insurance Covera~ <br />v <br />@IQI~3~3'S~ st~nBm.~teTw er ~ ~{ <br />°-' watage a .~p0 <br />~ .., f:edlOed Fee <br />O "" <br />_~•. <br />~ <br /> / <br /> r <br />S <br /> <br />O (R~e ~pelhrey <br /> <br />~ ~ 5. <br />b <br />Y 'yam ,, <br />@ <br />J <br />~ <br />~ Total Postage 8 FBe9 A q ~ (~ <br />~ `l " ~C ~ ~ q <br />~ 6~ t~ ~ <br />' <br /> , <br />rnWVt a <br />• <br />OO ~san i~ ~ ~li (~a{4~G~ .~ <br />f ~---- --!JO-v''a-----.~ <br />