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1 � <br /> t <br /> • X30 0001 7624 9601 <br /> A. Signatur 0 Agent n• n <br /> ■ Complete items 1,2,and 3.Also complete 0 Addressee ° OR m <br /> item 4 if i 3• e s <br /> ■ Print you a res o h reverse Prim Name) C. Date of Delivery m v m <br /> so that w S. Received by( <br /> we <br /> nz $s 8 & m <br /> ■ Attach this card to the back of the mailpiece1'C 0 Yes T m T „ s <br /> or on the front rf space permits. Y N D Is del'N address different from item 14 0 No <br /> If YES,enter delivery address below <br /> 1. Article Addressed to: : <br /> BLAINE DEJONG, ETAL. <br /> 324 N. CLUFF AVE. 3,Z Type <br /> 0 Ce'trfled Mail 0 Express Mail <br /> LODI, CA 95240 ❑Registered ❑Return Receipt for Merchandise <br /> 0 Insured Mall 0 C.O.D. 0 Yes <br /> 4. Restricted Delivery?(Ex0a Fee) <br /> . 8 <br /> aR <br /> 2. Article Number 7002 2030 0001 7624 9601 <br /> (transfer from service label) 102595-02-M-15x0 <br /> PS Form 3811,August 2001 Dommessttifrf w�eipt �� <br /> Rru- <br /> p V ®_ , <br />