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D
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Postage
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D Certified
Fee
D
Return
Receipt
Fee
D (Endorsement
Required)
D
Restricted
Delivery
Fee
r,J
(Endorsement
Required)
Lfl
.:,-
Total
Postage &
Fees
m
"SE,NDER:
COMPLETE THIS SECTION
""
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a Complete items 1, 2, and
3.
Also
complete
item 4
if
Restricted Delivery
is
desired,
II
Print your name-and address
o.n
the reverse
so that
we
can return the card
to
you.
= Attach this card
to
the
back
of
the
mailpiece,
or
on
the front
if
space permits.
$
$
Postmark
Here
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C.
Date
of
Delivery
l 1
/,,,),
<
1. Article Addressed
to:
D.
Is delivery address different from
Item
1?
□
Yes
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If
YES,
enter delivery address below: D No
3.
Se!Jl!Ce
Type
1B'
Certified
Mall
□
f;)l.press
Mall
D
Registered
s;;;:t"fietum
Receipt for Merchandise
□
Insured Mail □ C.O.D.
4.
Restricted
Delivery?
(Extra
Fee)
□
Yes
2.
Article
Number
(Transfer
from service
label)
7
□□
6
345
□
□□□□
1757
6043
PS Form 3811, February 2004 Domestic
Return
Rec~lpt 102595-02-M-1540'
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