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Z 224 364 336 <br /> US Postal Service <br /> Receipt for Certified Mail <br /> No Insurance Coverage Provided. <br /> Do not use for International Mail See reverse <br /> Sent to <br /> Street&Number <br /> BEVERLY STROUND <br /> SUNRISE CARE S REHABILITi <br /> 410 EASTWOOD AVE <br /> MANTECA CA 95336 <br /> Special Delivery Fee <br /> Restricted Delivery Fee <br /> on Return Receipt Showing to <br /> Whom&Date Delivered <br /> a Rehm Receipt Showing to Whom, <br /> a Date,&Addressees Address <br /> CDTOTAL Postage&Fees $ <br /> f0 Postmark or Date <br /> 0 <br /> LL <br /> W <br /> a <br /> SENDER: <br /> ,v_ •Complete items 1 and/or 2 for nddtiohal swi tes. I also wish to receive the <br /> Z -complete items 3,4a,and ib. following services(for an <br /> d •Pant your name and addretR on MeteWrse of thi$forte solhat we can return this extra fee): <br /> card to you. 0 <br /> -Attach this form to the front of the mailpiece,or on the back it space does not 1. ❑ Addressee's Address 'g <br /> d Aermit. `m <br /> y •Wnte'Refurn Receipt Requested'on the mailpiece below the article number. 2. ❑ Restricted Delivery N <br /> •The Return Receipt will show to whom the article was delivered and the date n <br /> delivered. Consult postmaster for fee. Z <br /> 04a.Article Number <br /> V 3. Article Addressed to: ' / + 1 <br /> ° BEVERLY STROUD 3rviceType <br /> E <br /> u SUNRISE CARE Sr REHABILITATION glistered Certified <br /> in 410 EASTWOOD AVE press Mail ❑ Insured <br /> old m % <br /> cc <br /> MANTECA CA 95336 tum Receipt for Merchandise ❑ COD <br /> p :e of Delivery <br /> a 'o <br /> Z 0- > <br /> n 5. Received By: (Print Name) H.Addressee's Address(Only it requested 2 <br /> F- and lee is paid) t <br /> Lu h <br /> 6. ignature: Addresse or Agent) <br /> 0 <br /> T <br /> n PS Form 11, December 1gs asseze-ane Domestic Return Receipt <br />