1275 NE 94 St (12)1. Article Addressed to:
2. Article Number
(Transfer from service let
91 i3HT1 013"d •- 40 d1J.I
SENDER: COMPLETE THIS SECTION
▪ Complete items 1, 2, and 3. Also complete
item 4 If Restricted Delivery Is desired.
■ Print your name and address on 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.
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PS Form 3811, February 2004 Domestic Return Receipt
— COMPLETE THIS SECTION _ON DELIVER Y"
A. Signature
X
B. Received by (Printed Name)
❑ Agent
❑ Addressee
C. Date of Delivery
D. Is delivery address different from item 1? ❑ Yes
If YES, enter delivery address below: ❑ No
ce Type
Certified Mall ❑ Express Mall
❑ Registered ❑ Retum Receipt for Merchandise
❑ Insured Mall ❑ C.O.D.
4. Restricted Delivery? (Extra Fee)
7003 0500 0005 5013 1545
❑ Yes
102595.02- M-1540
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0005 5013 1545 . 2.
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