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P -379 765 " E6&...._.....- <br /> us P4tal S.: I <br /> Receipt for Certified Mail K <br /> pate,&Addressee <br /> JEFFREY R & D G WAGNER <br /> 3776 W GRANTLINE RD <br /> TRACY CA 95376 t <br /> Postage <br /> certified Fee <br /> Special Delivery Fee <br /> Restricted Delivery Fee <br /> us <br /> am Retum Receipt Showing to <br /> r Whom&Date Delivered <br /> r- <br /> ' Retum Receipt Showing to Whom, <br /> Q 's Address <br /> Q TOTAL Postage&Fees $ <br /> Go <br /> t"7 Postmark or Daie�. <br /> ll <br /> tl " <br /> i m SENA <br /> ■Com' i or 2 for additional services I alsowish toreceive the <br /> t �'»■Cvmp ere items 14a,and 4b. follOwln SefV�C (fro <br /> 4 m ■Print your name and address on the reverse is form so rn t extra 2 j6 <br /> d - card to you. If <br /> 7 d <br /> ■ABach,this-form to tate hent of the mailpieos r o t 1. C3 Addressee's Address U <br /> permit. ` x-A r' "s�_ �1 <br /> y ■Write,Retdm-Receupr Requested"on the mMpi oe belo the article number. 2. © Restricted Delivery N <br /> "« ■The Retum Rec`eipt"Mil show to whom the article was delive'ed ah d the date + <br /> e delivered. •lr!''rY.. ' <br /> c I _ " Consult postmaster for fee. <br /> -o 3.Article Addressed to: 4eq Article Number <br /> CL JEFFREY K & D G WAGNER, <br /> EI- 4b.Service Type <br /> 0 3776 W GRANTLINE RD r <br /> T ❑ <br /> ACY CA 95376 Registered entified � <br /> w R <br /> ' u.l I ❑ Express Mail Insured c <br /> C ❑ Retum Receipt for Merchandise ❑ COD 3 <br /> 7. Date of Deliv ry <br /> �' �requestv <br /> 5.Releived By (Print Name) S.Addressee's AddsY <br /> ;. and fee is m <br /> 6.Signa tu Address e r e ) iE <br /> X 1� <br /> PS Form 3 , December 1 4 y omestic Return Receipt <br />