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COMPLETE •N COMPLETE THIS SECTION ON DELIVERY <br /> ■ Complete items 1,2;and 3.Also complete A. Signature <br /> item 4 if Restricted Delivery is desired. 13 Agent <br /> ■ Print your name and address on the reverse X ❑Addressee <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. <br /> �'_� D. Is delivery address different from item 1? El Yes <br /> 1. Article Addressed to: If YES,enter delivery address below: El No <br /> UNITRtCHARD•J KOOISTRA <br /> 1523 W RUTLEDGE WAY <br /> STOCKTON CA 95207 3. Service Type <br /> Certified Mail° 0 Priority Mail Express`" <br /> PRG BLLG 2ND QTR 2015 ❑Registered .Q-9eturn Receipt for Merchandise <br /> RE 1523 W. RUTLEDGE WAY,STKN ❑ Insured Mail ❑ Collect on Delivery <br /> 4. Restricted Delivery?(Extra Fee) ❑Yes <br /> 2. Article Number 7 014 2120 0004 7742 1376 <br /> (transfer from service label) <br /> PS Form 3811,July 2013 Domestic Return Receipt <br />