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;-,VENDER: COMPLETE THIS SECTION C�TVIPLETE THIS SECTION ON DELIVERY <br /> ■ Complete items 1,2,and 3. A. Signature <br /> ■ Print your name and address on the reverse ❑Agent <br /> X �, <br /> so that we can return the card to you. ❑Addressee <br /> ■ Attach this card to the back of the mailpiece, B•'Receive . d ame) C. Date of Delivery <br /> or on the front if space permits. <br /> 1. Article Addressed to: a Ivery address different from item 11 ❑Yes <br /> v I;YS, gs9tdelivery address below: ❑ No <br /> ' <br /> LSBANKTR c/o SELECT PORTFOLIO 11 uJloo <br /> 3277 S DECKER LAKE DR <br /> SALT LAKE CITY UT 84119 EMIL rWMENTAL HEALTH <br /> IP'S/NTS/PL'S/PKT P E RI IPSErRVICEUS N IT 11-H <br /> RE 712 S ANTEROS AVE., STKN <br /> I'IIIII I'I ('I II II I II II III II I II I II I II I I III 3. Service Type ❑Priority Mail Express® <br /> ❑Adult Signature ❑Registered Mail'"' <br /> ❑Adult Signature Restricted Delivery ❑Registered Mail Restricted <br /> ified Mail® Delivery <br /> 9590 9401 0058 5 0 71 6127 83 El Certified Mail Restricted Delivery �eturn Receipt for <br /> ❑Collect on Delivery erchandise <br /> 9 Artirla Ni imhvir(rransfer from service label) E]cc <br /> on Delivery Restricted Delivery 0 Signature Confirmation'"' <br /> lail ❑Signature Confirmation <br /> 7015 0640 0007 1118 &380 lail Restricted Delivery Restricted Delivery <br /> PS Form 3811,April 2015 PSN 7530-02-000-9053 Domestic Return Receipt <br />