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SENDER: c(,,;IPLETE THIS SECTION COMPLETE THIS SECTION ON DELIVEPY <br /> ■ Complete items 1,2,and 3.Also complete A. Signature <br /> item 4 iW,Tne e ❑Agent <br /> ■ Print yot reverse ❑Addressee <br /> SO that B. Received by(Printed t�7. 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? 11 Yes <br /> 1. Article Addressed to: if YES,enter delivery address below: ❑No Y <br /> KWIK SERVE <br /> 950 W 11TH ST 3. Service Type <br /> TRACY CA 95376 XCertified Mail ❑Express Mail <br /> ❑Registered ❑Return Receipt for Merchandise <br /> ❑Insured Mail ❑C.O.D. <br /> 4. Restricted Delivery?(Extra Fee) ❑Yes <br /> 2. Article Number <br /> (fransferfrom sen 7004 2512 0003 3789 1983 <br /> PS Form 3811,February 2004 Domestic Return Receipt 102595-02-M-1540 <br />