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{ ■ Comple 1yd1dd <br />d so mplete <br />` item 4 i ve i red. <br />■ Print yo a reverse <br />so that c n e e u. <br />■ Attach this card to the back of the mailpiece, <br />or on Vie front if space permits. <br />1 1. Article Addressed to: <br />GOVERNMENT BLDG <br />1722 E SCOTTS AVE <br />STOCKTON CA 9520.5 <br />A. Signature <br />❑ Agent <br />❑ Addressee <br />by (Printed Name) C. Date of Delivery <br />D. Is defivery address different from item 1? ❑ Yes <br />If YES, enter delivery address below: ❑ No <br />3. Service Type <br />,Certified 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 />(Transfer from service label) ?004 2 510 0003 3 7 8 9 3 611 <br />PS Form 3811, February 2004 Domestic Return Receipt 102595-02-M-1540 <br />