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■ Complete items 1, 2, and 3. Also complete <br />item 4 if Re*tricted isleeire - <br />■ Print your rtarne and ddess On Oe fkverse <br />,r <br />so that we can returrl th car,&W-Vo(A <br />■ Attach this card to the back of the mailpiece, <br />or on the, front if space permits. <br />1. Article Addressed to: <br />BALKAR SINGH <br />I I I I E KETTLEMAN LN <br />LOM GA 95240 <br />2. Article Number <br />{Transfer from service label) <br />PS Form 3811, February 2004 <br />A. Signature .4 ' <br />4El Agent <br />X k v ❑ Addressee <br />B. Received by (Printed Name) C. ate of Delivery <br />D. Is delivery address different from item 1? ❑ Yes <br />If YES, enter delivery address below: ❑ No <br />3. Service Type <br />*Certified Mail D Express Mail <br />❑ Registered ❑ Return Receipt for Merchandise <br />❑ Insured Mail ❑ C.O.D. <br />4. Restricted Delivery? (Extm Fee) ❑ Yes <br />70014 2510 0003 3789 3635 <br />Domestic Return Receipt <br />102595 -o2 -M-1540 <br />