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f <br /> WON <br /> ■ Complete items 1,2,and 3.Also complete lAgcnatureitem4 if Restricted Delivery is desired. !f ' r 204 ❑Agent <br /> ■ Print.your name and address on the reverse ❑Addressee <br /> so that we can return the card to you. ived by(Printed Name) C. Date of Delivery <br /> ■ Attach this card to the back of the mailpiece, <br /> or on the front if space permits. <br /> p, ter item 1? ❑Yes <br /> 1. Article Addressed to: low: ❑No <br /> CIWMB <br /> ATTN KEITH KENNEDY MS#15 JAN 2 7 2004 <br /> PO BOX 4025 [1 --.11.1. <br /> SACRAMENTO CA 95814-4025 3. Rei <br /> ss Mail <br /> Registered ❑ Return Receipt for Merchandise <br /> ❑ Insured Mail ❑C.O.D. <br /> 4. Restricted Delivery?(Extra Fee) ❑Yes <br /> 2. Article Number 7001 2510 0005 9632 3587 <br /> (Transfer from serviceJabelj <br /> PS Form 3811,August 2001 Domestic Return Receipt 102595-02-M-103: <br />