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Postal <br /> CERTIFIED MAIL RECEIPT <br /> (Domestic Mail Only;No Insurance Coverage provided) <br /> 0 <br /> uT <br /> ru <br /> m <br /> r Postage S <br /> R- <br /> a Certified Fee <br /> fl <br /> Return Receipt Fee Postmark <br /> (Endorsement Required) Here <br /> C3 .Restricted Delivery Fee <br /> C3 {Endorsement Required) <br /> rTotalP <br /> a FS"TO ATPN FREDMANDING <br /> aCLEMENTS RURAL FIRE DIST <br /> C3 P.O.BOX 523oCLEMENTS CA 95227 <br /> O <br /> r <br /> SENDER: <br /> •Complete items t ante for additional services. 1+!A !t / 90Q� I ai, 01}�sh t0 receive the <br /> Po •Complete items 3,4a,and 4b. "/i V f LU02 g services(for an <br /> tv •Print your name and address on the reverse of this form so that we can return this extra fee): <br /> card to you. <br /> • <br /> Attach this form to the front of the mailpiece or 1.❑ Addressee's Address <br /> ` permit <br /> N •Write"Return Receipt Requested"on the mai piece slow eartice number. 2.❑ Restricted Delivery d <br /> The Return Receipt will show to whom the article was deliveretl and the tlate N <br /> c <br /> delivered. <br /> Consult postmaster for fee. n <br /> 0 3.Article Addressed to: 4a.Article Number m <br /> 9 V <br /> m d <br /> do a 250 C <br /> a AT" FRED MANDING 4b.Service Type <br /> E CLEMENTS RURAL FIRE DIST ❑ Registered stered �CeifiedP.O.BOX 523 W <br /> CLEMENTS CA 95227 ❑ Express Mail ❑ Insured c <br /> ❑ Return Receipt for COD <br /> 7. Date of Deliv o` <br /> T <br /> 5.Received By: (Print Name) 8.Addressee' (Qe a fed Y <br /> and fee is <br /> m <br /> 6.Sign ur : (Addressee or AgeaV <br /> 0 <br /> a <br /> PS Form 3811,December 1994 102595-N--e-0229 DOMeStic eturn Receipt <br /> 1- <br />