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180 <br /> Z 016 yO '' <br /> MAILED SF? <br /> Receipt for <br /> CeKlfied Me " <br /> No Insurance Coverage Provided <br /> i Do not use for International Mail <br /> (See Reverse) <br /> Sent to <br /> MR JACK FULLER <br /> Street and No. <br /> P.O-,State and ZIP Code <br /> Postage <br /> Certified Fee <br /> Special Delivery Fee <br /> Restricted Delivery Fee <br /> inReturn Receipt Showing <br /> SRto Whom&Date Delivered <br /> r <br /> t Return Receipt Showing to Whom. <br /> Date,and Addressee's Address <br /> Old <br /> TOTAL Postage <br /> O &Fees <br /> O Postmark or Date <br /> co <br /> 0 <br /> E <br /> 0 <br /> 0 <br /> LL <br /> FJ1 <br /> a <br /> SE / I wish to receive the <br /> • o pie s n /of 2� n foil vices fifer @n p <br /> rn • mplete it and 4a&b. ARE-1) J E P (g .l <br /> • Print your name and address on the reverse fr so that a can fee). <br /> > return this card to you. Addressee's Address y <br /> y Attach this form to the front of the mailpiec , on the back space <br /> does not permit. a <br /> t • Write"Return Receipt Requested"on the mailpiece below the article number. <br /> 2. ❑ Restricted Delivery y <br /> • The Return Receipt will show to who the article was delivered and the date Consult postmaster for fee. ami <br /> c delivered. 4a. Article Nu ber <br /> c <br /> � 3. Article Addressed to: <br /> d 4b. Service Type cc <br /> Q. MR JACK FULLER <br /> El Registered ❑ Insured <br /> 0 6635 GRIGSBY PL ❑ c_ <br /> Certified COD <br /> N STOCKTON CA 95219 Express Mail E] Return Receipt for oz <br /> Merchandise c <br /> 7. Date of Delivery <br /> ;7. c,t O <br /> a <br /> 8. Addresse1e' Address (Only if requested x <br /> ZC 15. nature (A dres <br /> and fee Is d) L <br /> F- RI <br /> 6. Signature (Agent) <br /> 3 <br /> T PS Form 3811, December 1991 *U.S.GPO:1993-352-714 D ESTIC RETURN RECEIPT <br /> Ul ! <br />