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¦ 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 />MR SAM KEELING <br />516 E VIRGINIA <br />P0BOX361 <br />LAVETA, CO 81055 <br />IZ4?' A. Si/ <br />? Agent <br />? Addressee <br />2BRacc?elvedd by (Printed ?ame)) C1. Date of Delive <br />D. Is delivery address different from Item 1? ? Yes <br />If YES, enter delivery address below: ? No <br />J. Service Type <br />? Certified Mail ? Express Mail <br />? Registered ? Return Receipt for Merchandise <br />? Insured Mail ? C.O.D. <br />4. Restricted Delivery? (Extra Fee) ? Yes <br />2 Art icle Number <br />(Transfer from service label) ?008 1140 0004 5 015 4563 <br />PS Form 3811, February 2004 Domestic Return Receipt <br />102595-02-M-1540 <br />5.0-01 <br />?2jfo)? 9 <br />ik4 --( `717 C -Dif( <br />r4t-, kap/ fss