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D� - <br /> a •. A <br /> 'U <br /> M <br /> All <br /> M Certifi <br /> $ <br /> Extra es(check box,add lee as <br /> C3 ❑Return eceipt(hardcopy) $ aPpr Pdate) <br /> t] ❑Return Receipt(electronic) $ e <br /> IM ❑Certified Mall Restricted Delivery $ P ark <br /> C3 ❑Adult Signature Required $ <br /> ❑Adult Signature Restricted Delivery$ <br /> C3 <br /> CO 3 <br /> t-j <br /> ru ZOSIMO LOPEZ <br /> C3 , 1614 ROBERTS AVE <br /> SAN JOSE CA 95122-3832 <br /> COMPLETE <br /> ■ Complete items 1,2,and 3. A. Signature <br /> ■ Print yotar Tjn the reverse X p Agent <br /> so that ei to you. ❑Addressee <br /> ■ Attach this card to the back of the mailpiece, B. R eived (Punted N e) C.1Tte` Dili <br /> elivery <br /> or on the front if space permits. I I <br /> 1. Pr+ir lc n i iraccori rn• D. Is delivery address different from jteml 1 '❑Yes <br /> If YES,enter delivery address below: No <br /> ZOSIMO LOPEZ �ar,l , ••�,., <br /> 1614 ROBERTS AVE <br /> SAN JOSE CA 95122-3832 L:NN'W0NJN11-:.\ I kt. <br /> II I IIIIiI Iill III I IIIIIIII II II II II I I I I I I I II III 3. Service Type ❑Priority Man Express <br /> ❑Adult Signature ❑Registered MaIITM <br /> dult Signature Restricted Delivery ❑Registered Mail Restricted <br /> 9590 9402 6099 0125 5510 09 er fled MaM Delivery <br /> ❑Certified Mall Restricted Delivery ❑Return Receipt for <br /> O Collect on Delivery Merchandise <br /> +t to�I imhcr r7rYlnSfP.r from SeNICe/ebel) 13 Collect on Delivery Restricted Delivery ❑Signature ConfirmationTM <br /> ?0201810 0000 4003 2 619 all ❑Signature Confirmation <br /> - fall Restricted Delivery Restricted Delivery <br /> PS Form 3811,July 2015 PSN 753002-000_9053 Domestic Return c ipt <br />