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341,a3j-Loo 1v a;6:j <br /> i <br /> COMPLETE • ON <br /> COMPLETESECTION <br /> ■ Complete items 1,2,and 3.Also complete A. Signature <br /> ❑Agent <br /> item 4 if Restricted Delivery is desired. X O Addressee <br /> ■ Print your name and address on the reverse <br /> so that we can return the card to you. B. Received by(Printed Name) C. Date of Delivery <br /> ■ Attach this card to the back of the mailpiece, <br /> or on the front if space permits. EI Yes <br /> D. Is dR s different from it 1? <br /> 1. Article Addressed to: UNIT I I'N If Y ��d��s E3 NO <br /> MAY <br /> �,t �i <br /> RICHARD J KOOTSMA FA0016263 '•A L 5 2016 <br /> 1523 W RUTLEDGE WAY - <br /> STOCKTON CA 95207 3. Servicvjy �} �rH <br /> �'ti✓ertified Matl����u>6i Mail Express'" <br /> PRG BLLG 1S1 QTR 2016 0 Registered --'IS-Return Receipt for Merchandise <br /> RE 1523 W.RUTLEDGE WAY,STKN 0 Insured Mail ❑Collect on Delivery <br /> 4. Restricted Delivery?(Extra Fee) ❑Yes <br /> 2. Article Number 7 014 2120 0004 7741 5948 <br /> (Transfer from service label) _ <br /> PS Form 3811,July 2013 Domestic Return Receipt <br />