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^ Complete items 1, 2, and 3. Also complete <br />item 4 ii 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 />11~,~, x;11 ~la~^k <br />~r o. ~~ /9,,~ <br />a Si at re <br />X /U ^ Agent <br />^ Atltlressee <br />B. Received by (Pooled Name) C. Date of Delivery <br />D. Is delivery atldress different from <br />if VFS, emer delivery address h <br />'° .-+ <br />~~ <br />3. Service Type ~~ <br />^ Cer[ifled Mail ^ Express M ~ <br />^ Registered ^ Retum Receipt for Merchandise <br />~ Insured Mail ^ C.O.D. <br />4. Restdctetl Delivery? (Extra Fee) ^ yes <br />2. Article Number r 704 1350 pp01 1636 6476 <br />(fiansfer from service labeq <br />Ps FORn 3811, February 2004 Domestic Return Receipt 102595-02.M-1560 <br />Permit #: m -~d~ -~29 Confidental?: /~a <br />Class: -nrfo,PsEn~EHT MV# <br />From: C~F.~-ND Cogu'r7 o at.*nr` To: Drn(~ <br />Doc. Name: eQ2TIFl~ Mrtl~'2ECEiPi <br />Doc. Date (if no date stamp): n 3i n 6 SectionlExh. <br />Inspection Date N/A Specialist: 2M_ W ~PrM <br />