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Receipt for <br /> Certified <br /> Insurance Covera e Provid <br /> ��L* No Ins n a'o l ail <br /> Do not use for <br /> POv��"T- (See fleversel <br /> Sent to <br /> ROBERT A--SELIGSO <br /> Street and No. <br /> 6. :KING�:A�IE <br /> State and ZIP Code <br /> PIEDMONT CA $ . �� <br /> Postage <br /> Certified Fee <br /> Special Delivery Fee <br /> Restricted DeVivery'Fee <br /> Return Ae,elpt Showing <br /> to Whom&Date Delivered <br /> Return Receipt Showing to Whom, <br /> c Date,and Addressee's Address <br /> TOTAL Postage <br /> &Fees . <br /> Postmark or Date00 <br /> t <br /> M <br /> C a <br /> LL wm <br /> a �� <br />