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SENDER: COMPLETE THIS SECTION COMPLETE THIS SECTION ON DELIVERY <br /> ■ Complete items 1,2, and 3.Also complete A. Signature <br /> item 4 if Restricted Delivery is desired. X ❑Agent <br /> ■ Print your name and address on the reverse ❑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 /> D. Is delivery address different from item 1? ❑Yes <br /> 1. Article Addressed to: If YES,enter delivery address below: ❑No <br /> RICHARD J. KOOISTRA RIECEPAED <br /> 1523 W RUTLEDGE WAY <br /> STOCKTON CA 95207 3. Service Type JAN 2 6 WILT <br /> Certified Mail ❑ Express Mail <br /> SOE BNC ❑ Registered ❑ Return Receipt for MerchandisENVIRONMENT 1!-AL1f1 <br /> El <br /> Mail ElC.o.D. PERMIT/SEA /ICES <br /> RE 1523 W RUTLEDGE WAY, STKN 4. Restricted Delivery?(Extra Fee) ❑Yes <br /> 2. Article Number 7006 0810 0000 6564 3176 <br /> (transfer from service label) <br /> PS Form 3811, February 2004 Domestic Return Receipt 102595-02-M-1540 <br />