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■ Complete items 1, 2, and 3. Also complete A. Si ture <br />item 4 i ❑ Agent <br />■ Print yo�Idir a reverse X / 11 Addressee <br />so that e u, )7c ived b (Printed Name) C. Dae of gelivery <br />■ Attach this card to the back of the mailpiece, C/ <br />or on the front if space permits. P- <br />D. Is delivery address different from item 1? ❑ Yes <br />1. Article Addressed to: If YES, enter delivery address below: ❑ No <br />PACIFIC BELL <br />PERMIT DESK <br />PO BOX 601883 <br />SACRAMENTO CA 95860 <br />3. S rvice Type <br />,q 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 7004 2510 0003 3789 3116 <br />(Transfer from service label) <br />PS Form 3811, February 2004 Domestic Return Receipt 102595-02-M-1540 <br />