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■ Complete items 1,2,and 3.Also complete A. i ature
item 4 if Restricted Delivery Is desired. Agent
■ Print your name and address on the reverse Addressee
so-that we can return the card to you. _ R irad ( t ame) C. to f Delivery
■ Attach this card to the back of the maiipiece,
or on the front if space permits. U '
D. Is delivery address different Item 1? ❑Yes
1. Article Addressed to: if YES,enter delivery address below: ❑No
Matc.�a C-,. ca,k.sou�
3. Service Type
o y�CSOAJ b Certlfiad Mail o Express Mall
❑Registered ❑Return Receipt for Merchandise
o Insured Mail ❑C.O.D.
4. Restricted Delivery?(Extra Feel ❑Yes
2. Article Number: {70 297Q Otla�d 46961 3900111;
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PS Form 3811,February 2004 Domestic Return Receipt 102595-02,fA=1540
UNITED STATES POSTAL SERVICE - First-Class Mail
Postage&Fees Paid
USPS
Pe G-10
• Sender: Please print your name, address, and ZIP+ Is s
e
1, Glen Fanner Sgasbaugh 2013
° legiggr of�ls and Clerk of Orphans' S°`
L-011to of,Ctigl°sland
l ne urthi6ifst�ijuare
earlisle, PX--.1�
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