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SENDER: COMPLETE THIS SECTION COMPLETE THIS DELIVERY <br /> ■ Complete items 1,2,and 3. A. Signature <br /> ■ Print your name and address one reverse X ❑Agent <br /> SO that We C� ��y0u. ❑Addressee <br /> ■ Attach this C o he mailpiece, B. Received by(Printed Name) C. Date of Delivery <br /> or on the front if space permits. <br /> 1. Article Addressed to: D. Is delivery address different from item 1? ❑ Yes <br /> If YES,enter delivery address below: ❑ No <br /> EFREN lkiJINEZ <br /> PO BOM 4 <br /> RIVERB ,i CA 95367-1197 <br /> I I III II III II I III III II I I I I II I I I III <br /> Service Type 11 Priority Mail - sOO <br /> 11 <br /> ❑Adult Signature El Registered MailaiIT"' <br /> Restricted Delivery ❑Registered Mail Restricted <br /> 9590 9402 6099 0125 5508 59 ❑Delivery <br /> Return Receipt for <br /> Collect on Delivery Merchandise <br /> 2. Article Number(Transfer from service label) ❑Collect on Delivery Restricted Delivery ❑Signature Confirmation- <br /> 0 <br /> Insured Mail ❑Signature Confirmation <br /> ail Restricted Delivery Restricted Delivery <br /> 7020 1810 0000 3998 7050 <br /> PS Form 3811,July 2015 PSN 7530-02-000-9053 Domestic Return Receipt <br />