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■ Complete Items t, 2, and 3.
I ■ Print your name and address on the reverse
! so that we can return the card to you.
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t. Article Addressed to:
107 ,5hmK D4/
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9590 9402 2736 6351 5756 93
7015 3010 0000 7848 9850
X
B.
❑ Agent
D. Is delivery address different from Item t? ❑ Yes
If YES, enter delivery address below: ❑ No
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