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COMPLETE THIS SECTION ON DELIVERY <br /> ■ Complete items 1,2,and 3.Also complete A. Received by{Plea rint Clearly) B. Date of Delivery <br /> item 4 if Restricted Delivery is desired. <br /> ■ Print your name and address on the reverse C. Sig re Agent <br /> so that we can return the card to you. 0 Addressee <br /> ■ Attach this card to the back of the mailpiece, )( <br /> or on the front if space permits. D. Is delivery address differe from item 1? 0 Yes <br /> 1. Article Addressed to: <br /> 6f YES,enter delivery address below: ❑ No <br /> AGNES M BALOT <br /> LATHROP CHEVRON 3. Service Type <br /> 140 LATHROP RD <br /> Certified Mail ❑ Express Mail <br /> LATHROP CA $5330 0 Registered 0 Return Receipt for Merchandise <br /> .0 Insured Mail 0 C.O.D. <br /> 4. Restricted Delivery?(Extra Fee) 0 Yes <br /> from service label} I 40 L�TM��p fl <br /> 2. Article Number(Copy I OV 19 2761 A V 102595-Oo-Mti-0952 <br /> PS Form 3811,duly 1999 Domestic Return Receipt <br />