1206 Crystal Ct Returned Certificationi
• 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.
1 Article Addressed to:
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A. Signature
X ❑ Agent
❑ Addressee
B. Received by ( Printed Name) I C. Date of Delivery
D. Is delivery address different from item 1? ❑ Yes
If YES, enter delivery address below: ❑ No
3. 5, a Type
Certified Mail ❑ Express Mail
❑ Registered f-0 Return Receipt for Merchandise
❑ Insured Mail ❑ C.O.D.
4. Restricted Delivery? (Extra Fee) ❑ Yes
2. Article Number
[Transfer from service label) 1 c C> C t S 3 r' (.6c(73 `A " =q
PS Form 3$11, February 2004 Domestic Return Receipt 102595.02 -M -1540
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