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■ Complete items 1, 2, and 3. Also complete <br />item 4 if Restrictgq,Qglivfired. <br />■ Print y/6jr1'11 kadd s he reverse <br />so that w ur them t;you. <br />■ Attach #1 ca t e back of the mailpiece, <br />or on the front if space permits. <br />1. Article Addressed to: <br />BANL Ait NR <br />C o Mr. Norm <br />I I 1 D <br />C 4 �tS2o 1 <br />A. Signat <br />X ❑ Agent <br />L ❑ Addressee <br />B. Received (Printe ame) C. *Aivo ry <br />Dttt---���I��Iss delivery address different fro ? Y <br />�r elow: ❑ No <br />JUIN 2 12005 <br />bgWRONWIVTT <br />�yf�1 pH ns Mail <br />❑ Regist re ( turn Receipt for Merchandise <br />❑ Insured Mail ❑ C.O.D. <br />4. Restricted Delivery? (Extra Fee) ❑ Yes <br />2. Article Number 7003 2260 0003 3185 9021 <br />(Transfer from service label) �V f' <br />1 PS Form 3811, August 2001 <br />Domestic Return Receipt <br />102595-01-M-25091 <br />