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i <br /> a <br /> I <br /> I <br /> Z 128 784 365 <br /> r <br /> US Postal Service <br /> Receipt for Certified Mail <br /> Ala.lnsuranca..CovaraaePjvided_ <br /> 3r5B <br /> W T JORDANc <br /> 1101 HOLLY DR <br /> TRACY' CA 95376 <br /> Postage _ $ ~ <br /> Certified Fee <br /> Special Delivery Fee <br /> Restricted Delivery Fee <br /> rq f <br /> Return Receipt Showing to <br /> r Whom&Date Delivered <br /> Retvm Recut Showeg to Wham <br /> Q Dale,&Addressee's Address <br /> 0 TOTAL Postage&Fees <br /> Postmark or Date <br /> 0 <br /> d <br /> COMPLETE <br /> ■ Complete item 2,elivery is desired.Uand 3.Also complete <br /> A. Received by(Please Print Clearly) D e of livery fi , <br /> ite 4 1 ve <br /> + ■ P t ame and address on the reverse <br /> S we can return the card to you. Si nature + <br /> ■ Attach this c the back of the mailpiece, X ❑Agent ; <br /> or on ttazfrojOuale3er 0 SNIT IV 11 Addressee <br /> 1. Article Addressed to: D. Is delivery address di ent from item 1. ❑ Yes <br /> It YES,enter delive address below: ❑ No <br /> ! P, ` <br /> W T JORDAN <br /> 1101 HOLLY DR <br /> TRACY 3. Se ice Type <br /> 95376 ertified Mail ❑ Express Mail <br /> ❑ Registered ❑ Return Receipt for Merchandise a <br /> - 0 Insured Mail ❑C.O.D. <br /> 4. Restricted Delivery?(Extra Fee) ❑Yes <br /> 2. Article Number(Copy from service label) <br /> C <br /> PS Form 3811, ly 19$9 es ac Return Receipt 102595-99-M-1789 n <br />