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59 425 481 .. <br /> 2 6 �._ <br /> Lai servi <br /> us V6i Mill <br /> t for Certified <br /> OSSETTI <br /> LIRA R LONE TREE RD <br /> 25411 CA 95320 <br /> ESCALON <br /> Postage <br /> Certified Fee <br /> special Delivery Fee <br /> Restricted Delivery F- <br /> in <br /> Retum Receipt Showing to <br /> r v�twm&Date Delivered <br /> =Q RetumReceipl 4toWhom, <br /> Q Date,&Addressee s Address <br /> p TOTAL Postage&Fees <br /> � post mark or Date <br /> 0 <br /> w <br /> N <br /> •— I also wish to receive the <br /> $E following} 1°c n <br /> y ■C plete items 1 andlor 2 for additional services• e n ret this extra <br /> m ■Complete items 3,4a,and 4b. of ' rm <br /> w ■Print your name and address on the revs of 1 ❑ Addressee's Address <br /> to card to you. m <br /> d ■Attach this form to the front of the Mal ce <br /> permit:' nested'on the madpre ow the article number. 2❑ Restricted Delivery a <br /> m ■Write'Aetum Receipt Requested' e s delivered and the date Consult postmaster for fee. u <br /> r ■The Return Receipt will show to whom the artid <br /> delivered. . Article Number ac <br /> 3.Article Addressed to: <br /> - �.7- c <br /> Y <br /> Service Type certified <br /> °' LIDS' I�OSSE7'TI <br /> E TREE RD Registered ❑ Insured <br /> c°r 2 5 11 LUBE 8 3 2 0 ❑ Express Mail <br /> ESCAI,QN CA ❑ FtetumReceipt for Merchandise ❑ COD <br /> 7.Date of Delivery- <br /> o r <br /> a if re ueste ',v <br /> 8.Ad sae's Address(OAIY s <br /> 5.Received By. (Print Name) a s paid) <br /> I•- <br /> W <br /> °GAddres a or-Agent) e <br /> 6.Si na e: <br /> `" X DorTtestic Return Receipt <br /> PS Form 3811, December 1994 <br />