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i <br /> I <br /> m SEN I also wish to receive the <br /> o ■� e r for dditional se es. following services(for an <br /> m ■Co plate items 3,4a,and 4b. return this <br /> m . ■Print your name and address on the reverse of this forms n extra <br /> i card to you. /('' i a doe t, �' SS <br /> d ■Attach this form to the front of the mailpi�l� r <br /> permit. ^i . <br /> ■Write'Aetum Receipt Requested'on the ilp o t i e 2. ❑ Restricted Delivery <n <br /> Y ;■The Return Receipt will to who the anti a was d ivered and t e date <br /> Consult postmaster for fee. 4 <br /> c delivered. <br /> 0 4 rticle Number <br /> d' <br /> d DONALD E MASON <br /> 4b.Service Type <br /> TRACY DISPOSAL SERVICECertified <br /> ❑ Registered <br /> 0 <br /> 560 TRACY BLVD Insured <br /> (n i❑ Express Mail ❑ <br /> N TRACY CA 95376 <br /> ❑ Return Receipt for Merchandise ❑ COD w , <br /> v 7.Date of Delivery <br /> Q <br /> i <br /> Z, Y <br /> Received By:(Print Name) B.Address e' ddress(Only if requested <br /> w (', S and fee is ai ) F <br /> X <br /> 4 g 6.Signat : (Ad dr ssee or g nt) <br /> 0 X i <br /> Ps Form 3811, ecember lssa D mastic Return Receipt f <br /> i <br /> P� 590 4'24 S83 <br /> DONALD E MASON ti <br /> TRACY DISPOSAL SERVICE I <br /> i I <br /> 560 TRACY BLVD it <br /> i TRACY - CA_ 953761 <br /> JAN 2 1-10a, <br /> a�{ <br /> Postage <br /> Certified Fee ` <br /> t Special Delivery Fee <br /> F <br /> t Restricted Delivery Fee <br /> e <br /> � Return Receipt Showing to - • .. � <br /> Whom&Date Delivered <br /> n Q Return Receipt Showing to Whom, , <br /> Q Date,&Addressee's Address <br /> TOTAL Postage&Fees <br /> M PgaLmark or Da <br /> € , <br /> LL <br />