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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 />Am- <br />�� GZ) 9-s-a-0 <br />A. Signature <br />X vim% <br />B. Received by ( Printed Name) <br />❑ Agent <br />C. Date of Delivery <br />D. Is delivery address different from item 1? ❑ Yes <br />If YES, enter delivery address below: ❑ No <br />3. Servic Type <br />ertifled 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 7 010 1 0 6 0 0001 0 9 3 6 9317 <br />(Transfer from service label) <br />PS Form 3811, February 2004 <br />Domestic Return Receipt 102595 -02 -M -1540 <br />M ^ -goo -01Z <br />