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21201 S. SANTA n ROAD (APN! 249-060- 1) <br /> SENDER; I a the <br />'a E complete items' -dlo'2 itional services. fol also <br /> wi Zemsi(yforan <br /> Z m Complete itemal , lowin <br /> 3.4 and fe# <br /> 0 m Print your name and addres.430the reverse of this form so that we can return this extra <br /> card to you <br /> Attach this jorm to the front of the mailplece,or on the back if space does not 1. 0 Addressee's Address 2 <br /> permit. 0 <br /> mWrlteReturn Receipt Requested`on the mailpiece below the article number. 2. 1:1 Restricted Delivery 0 <br /> a The Return Receipt will show to whom the article was delivered and the date S <br /> delivered. Consult postmaster for fee. <br /> ° 4a.ArticleNumber <br /> 3.Article Addressed to: W <br /> Z 228 988 997 1 1 <br /> 4b.Service Type <br /> E I <br /> 0 BILL LANE 0 Registered 2 Certified <br /> a 1 <br /> 23125 S. HENRY ROAD [I Express Mail [3 Insured G I <br /> RIVERBANK, CA 95320 0 Retum Receipt for Merchandise 0 COD <br /> 7.Date of Delivery <br /> z <br /> Addressee's Address(Only ff requesteT- <br /> 5.Received By:(Print Name) 8. C <br /> and fee is paid) <br /> -�--Egntur-�'(Addressee Addressee or Agent) <br /> X- 1 V r c). <br /> RSForm 3811 Decetuber iW4 Domestic Return Receipt <br />