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M - - - <br />rr. Coverage Provided) <br />For delivery information visit our website at www.usps.c.—. <br />o- <br />O <br />C3 <br />`n Postage: <br />M Certified Fee: �85 '1 <br />E3 (I Return Receipt Fee: ! `� $2 1 ► r- <br />c3 (I Total Postage & Fees: $5.70 -' <br />n I Total Postage & Fees I zI> <br />Er Sent To <br />O <br />•---------------------------------- <br />� Street, Apt. No.; � -• ' <br />or PO Box No. <br />City, State, ZIP +4 <br />--- -------------------- --------------- - - -- <br />Cc, SI) Sot <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 />A. Slgna <br />X ) —� ❑ Agent <br />❑ Addressee <br />B. Received by (Printed Name) C. Date of Delivery <br />D. Is delivery address different from item 1 ? ❑ Yes <br />If YES, enter delivery address below: ❑ No <br />3. S�ery e Type <br />O 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. Article Number <br />(Transfer from service label) 7009 2 8 2 0 0003 5 7 01, 0943 <br />PS Form 3811, February 2004 Domestic Return Receipt _ 102595 -02 -M -1540 <br />0, � 'S <br />j44C <br />