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COMPLETE •N COMPLETE THIS SECTION ON DELIVERY <br /> ■ Complete items 1,2,and 3.Also complete A. Signature <br /> item 4 if Restricted Delivery is desired. yy 13Agent <br /> ■ Print your name and address on the reverse X ?./" ❑Addressee <br /> so that we can return the card to you. B. Received by(Printed Name) C. Date of Delivery <br /> ■ Attach this card to the back of the mailpiece, <br /> or on the front if space permits. <br /> 1. Article Addressed to: D. Is t e y1JCldrW4dit Brent;rQW itQ 1? ❑Yes <br /> If 1E ,enter deFvtry gd0Jges9bel6w: ❑ No <br /> JJSELMENDEZ FEB 17 2015 <br /> 2%2:5B ST <br /> STOCKTON CA 95206 EWMtN 3 , 64 <br /> L HEALTH <br /> PRG BLLG 12 31 14 15,Cetf XPrMiP66WWMail Express'" <br /> ❑Registered —15-Return Receipt for Merchandise <br /> RE 2962 S B ST.,STKN ❑ Insured Mail ❑Collect on Delivery <br /> 4. Restricted Delivery?(Extra Fee) ❑Yes <br /> 2. Article Number 7013 2630 0001 5222 4448 <br /> (Transfer from service label) <br /> PS Form 3811,July 2013 Domestic Return Receipt <br />