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Z 178 0179 794 <br /> US Postal Service <br /> Receipt for Certified Mail <br /> No Insurance Coverage Provided. <br /> Do not use for International Mail See reverse <br /> Sent to LINCOLN VILLAGE <br /> Street& MA <br /> Postoffj t8t�tk°tff' 'CA 95209 <br /> Postage $ <br /> Certified Fee <br /> Special Delivery Fee <br /> �J <br /> Restricted Delivery Fee <br /> N <br /> 13)0) Return Receipt Showing to <br /> c Whom&Date Delivered <br /> Cl- <br /> < d <br /> Return Receipt Showing to <br /> Whom, <br /> Return <br /> &Addressee s Address <br /> OTOTAL Postage&Fees $ <br /> Postmark or Date <br /> E <br /> 0 <br /> LL <br /> a <br /> SENDER' I also wish to receive the <br /> ■Complete items 1 and/or 2 for additional services. following services for an <br /> Yl ■Complete items 3,4a,and 4b. extra fee): ai <br /> rn ■Print your name and address on the reverse of this form so that a ca urn this U <br /> card to you. <br /> > ■Attach this form to the front of the mailpiece,or on the back if space does not 1. ❑ Addressee's Address <br /> 4) permit. «� <br /> ■Write-Return Receipt Requested'on the mail below the article number. 2. ❑ Restricted Delivery a <br /> ■The Retum Receipt will show to whom the article was delivered and the date Consult postmaster for fee. <br /> u <br /> Cm 3d.elivered. 4a.ArticleNumb r <br /> cArticle Addressed to: <br /> G �cIV 'i- <br /> 4b.Service Type <br /> cLINCOLN VILLAGE ❑ Registered 0--Certified <br /> WEST MARINA LT ❑ Express Mail ❑ Insured E <br /> qCADERO DR <br /> ❑ Retum Receipt for Merchandise ❑ COD <br /> 6649 EMBARCADERO <br /> °C STOCKTON CA 952097.Date o Deliv ry :3O o <br /> Q <br /> eqY <br /> Z 8.Ad resse s Address(Onlycc <br /> uested <br /> 5.Received By: (Print Name) and fee is paid) L <br /> F- <br /> W <br /> W <br /> S <br /> 6.Signature: ( ressee or AgePt) <br /> C ' <br /> X T� <br /> 102595-97-8-0179 Domestic Return Receipt <br /> PS Form 3811, December 1"14 <br /> t ` <br />