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Postal <br /> (DomesticCERTIFIED MAIL,. RECEIPT <br /> Lr Provided) <br /> rr Postage $ <br /> rr <br /> Certifier'Fee <br /> Postmark <br /> Return Reclept Fee Here <br /> (Endorsement Required) <br /> Restricted Delivery F-le <br /> (Endorsement Regmred) <br /> Total Postage&Fees $ <br /> Sfreet. Nom,- ---------------------- 55�� <br /> or PD Box No. <br /> P O .IS C'K - ------- <br /> ------------------------------- <br /> City State,ZIP+4 <br /> .r. r. <br /> COMPLETE THIS SECTION <br /> ON <br /> SENDER: COMPLETE THIS SECTION <br /> A. Sign e <br /> ■ Complete ite s 1,2,and 3.Also complete E3 Agent <br /> ite fjast lircs=$ <br /> d 'red. X ❑Addressee <br /> ■ Pri t n ado the reverse <br /> sOh�'� lit n t1-ti <br /> You. t{y qP d Name) C. Date of Delivery <br /> ■ Attach this c d to the back of the mailpiece, <br /> or on the from if space permits. W Ye <br /> s de every address dy ere t from item 1? 0 Nos <br /> 1. Article Address d to: Ifn YES enter deliver address below: <br /> AR <br /> s n � Lvl� x <br /> 5 22 -r ma rKeA 1 <br /> P ►J� 5 5 a— —4 3. Servi <br /> w d, C-4A (Certified Mail ❑ Express Mail <br /> t 9 d 5.4,5 ❑ Registered ❑ Return Receipt for Merchandise <br /> / T ❑ Insured Mail ❑ C.O.D. <br /> 4. Restricted Delivery?(Extra Fee) ❑Yes <br /> 2. Art cle Numbe <br /> (T 7003 2262 0003 318 5 9056 <br /> sfer from ervice label) <br /> PS F rm 3811 February 2004 Domestic Return Receipt <br /> 102595-02-M-1540. <br />