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■ Complete items 1, 2, and 3. Also complete <br />item 4 e d. <br />■ Printyo�reverse <br />so that Th1 <br />e u. <br />■ Attach this card to the back of the mailpiece, <br />or on the front if space permits. <br />1. Article Addressed to: <br />QUIK STOP MARKETS #138 <br />1153 LINCOLN BLVD <br />TRACY CA 95376 <br />A. Signature � <br />x - e� I -Agent <br />B. Received by ( PrintedName) C. Date of Delivery <br />r 1a, 'A --t <br />D. Is delivery address different from item 1?'_ , Yes IF <br />If YES, enter delivery address below: ❑ No <br />RC 2 7 2004 <br />3. Service Type , v __11 <br />)�LCertified Mail ❑ Express Mail <br />❑ Registered ❑ Return Receipt for Merchandise <br />❑ Insured Mail ❑ C.O.D. <br />4. Restricted Delivery? (Extra Fee) ❑ Yes <br />�. NaING I-1 IUCI -- <br />(Transfer from service label) 7004 2 510 0003 3789 1433 <br />PS Form 3811, February 2004 Domestic Return Receipt 102595-02-M-1540 <br />