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■ Complete items 1, 2, and 3. Also complete item 4 if Restricted Delivery is desired. ■ Print your name and address on the reverse so that we can return the card to you. ■ Attach this card to the back of the mailpiece, or on the front if space permits. 1. Article Addressed to A. Signatu � Agent Jy ❑ Addre B. Received by ( Print ame) T rtDfte Of Pel ❑ Yes 0 No - - . Postal Service PACIFIC STATE BANK I HEALTH RTIFIED MAIL RECEIPT F WUR STOCKTON CA 95201-1649 mestic Mail Only; No Insurance Coverage Provided) 0 Registered ❑ Return Receipt for Merchandise 0 Insured Mail ❑ C.O.D. For delivery intormatlon visit our website at vnvw.usps.comCariffied 2. Article Number 7009 3410 0001 8274 5960 (Transfer from service label) PS Form 3811, February 2004 Domestic Return Receipt 10259542-1+1-t s4o 1-11 Postage r)� Fee. Pealrvark Relum R%:Ilpt Fee Hers Restricted Delitary Fee C3 (Endorsement Required) rq -r Total Post PACIFIC. BOX :o: 64 AURORA PS Form 3800. Au us12n0f.. Sce Reverse for Inslmctions ■ Complete items 1, 2, and 3. Also complete item 4 if Restricted Delivery is desired. ■ Print your name and address on the reverse so that we can return the card to you. ■ Attach this card to the back of the mailpiece, or on the front if space permits. 1. Article Addressed to A. Signatu � Agent Jy ❑ Addre B. Received by ( Print ame) T rtDfte Of Pel ❑ Yes 0 No - - SEP 2 4 L010 PACIFIC STATE BANK I HEALTH PO BOX 1649 WUR STOCKTON CA 95201-1649 3. se We rtified Mail ❑ Express Mail R➢: 05 AURORA ST ATNRW 0 Registered ❑ Return Receipt for Merchandise 0 Insured Mail ❑ C.O.D. 4. Restricted De1WW (Extra Fee) 0 Yes 2. Article Number 7009 3410 0001 8274 5960 (Transfer from service label) PS Form 3811, February 2004 Domestic Return Receipt 10259542-1+1-t s4o