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i <br /> yo p to 1 andJor 2 for additional ser ces. I also Wish to receive the .. <br /> • <br /> Complete items 3,and 4a&b. following s fce f r an m <br /> • <br /> Print your name and address on the raveffece ., <br /> �q�r so at we can <br /> fee): 1 '� <br /> return this card to you. Y�� d <br /> d • Attach this form to the front of the mailn the ba if space 1. ❑ Addressee's AddreSS CO) <br /> does not permit. 4- <br /> Write <br /> Write"Return Receipt Requested"on the mailpiece below the article number. Restricted Delivery <br /> Q <br /> 2. ❑ m <br /> • The Return Receipt will show to whom the article was delivered and the date <br /> o delivered. Consult postmaster for fee. f0 <br /> -0 3. Article Addressed to: 4a. Article umber <br /> CL ATTN BETTY OWEN 4b. Service Type cc . <br /> E CHEVRON USA �Express <br /> ❑ Registered ❑ Insured <br /> P O BOX 5004 Certified ❑ CODUj SAN RAMON CA 94583�-0-7 <br /> 04 Mail ❑ Return Receipt for uWMerchandise c <br /> I <br /> Q 7. Date of Delivery <br /> (c _ r <br /> Z 8. Addressee's Ad e^ (Only if requested.� <br /> 5. gnatur (Add ssee) <br /> 3 <br /> and fee is paid <br /> H <br /> U.11 <br /> "naAge ) f <br /> T orm 3811 ecember 1991 *U.S.GPO:1993-352-714 DO STIC RETURN RECEIPT <br /> t + <br /> Z 016 974 . 238 i <br /> eceipt Tor7q= ! <br /> - Certified Mail <br /> No Insurance Coverage Provided -.;; <br /> ATTN BETTY OWEN <br /> CHEVRON USA ' <br /> P. 0 BOX '5'0 0 4 ` <br /> SAN RAMON CA .94583-0804 <br /> Postage - + <br /> 1 t <br /> Certified Fee <br /> Special Delivery Fee r <br /> Restricted Delivery Fee <br /> co •` <br /> Return Receipt Showing <br />� O1 to Whom&Date Delivered. <br /> ,= Return Receipt Showing to Whom,. ' <br /> Date,and Addressee's Address ? �; <br /> TOTAL Postage - <br /> r t9O &Fees <br /> CDPostmark or Date - <br /> M <br /> t LL <br /> a� <br /> f z <br />