Laserfiche WebLink
--N DER: COMPLETE THIS SECTION COMPLETE THIS SECTION ON DELIVERY <br /> Complete items 1,2, and 3.Also complete A. Signature <br /> Item 4 if Rerdu x ❑Agent <br /> Print your n � s t arse Address❑ i <br /> so that we c e a e. Received by( Name C. D to o D ivery <br /> A this card to the back of the mailpiece, 17 <br /> or on the nt if space permits. '- <br /> D. Is delivery address event -i <br /> m n 17 - ri _ <br /> Article Addressed to: If YES,enter delivery address below: 0 No <br />�AI n14; I �iNC�iE Knmbo� OCT 10 2003 <br /> Lf pc) S. µw\y 9q f rONJ tR- ENVIHOI�\ v i HEALTH <br /> RVICES <br /> NgN')¢CA ( CAr 85336 <br /> 3. Service Type <br /> X Certified Mail 0 Express Mail <br /> ❑ Registered 0 Return Receipt for Merchandise <br /> 0 Insured Mail ❑C.O.D. <br /> 4. Restricted Delivery?(Extra fee) 0 yes <br /> Article Number 7002 2030 0001 7624 8758 <br /> (transfer from service label) <br /> S Form 3811,August 2001 Domestic Return Receipt 102595.01-W2509 <br /> E N ,, r • <br /> 4 <br /> s; a <br /> q a 5 <br /> � • 0 0 �� LL0 LL 2',Sl� <br /> Ej vE u o Rm 'y <br /> W210 <br /> 9s Z8 h291- 1000 ❑E02 2002 <br />