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COMPLETE1 <br /> ■ Complete items 1,2,and 3.Also complete A. Signature <br /> item 4 If Restricted Delivery is desired. ❑Agent <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 /> D. Is delivery address different from item 17 ❑Yes <br /> 1. Article Addressed to: If YES,enter delivery address below: ❑No <br /> DD <br /> RICHARD J KOOISTRA <br /> 1523 W RUTLEDGE WY <br /> STOCKTON CA 95207 3. Se aType <br /> �I �fv Mail <br /> NTA RTN TO FLDR o q. �� etGceipifor Merchandise <br /> RE 1523 W RUTLEDGE,STKN ❑Insured 1�t� � <br /> 4. Restricted Delivery?(Extra Fee) ❑Yes <br /> 2, ArticleNumber7008 0150 0000 8147 8342 <br /> (fransler from service labeq <br /> PS Form 3811,February 2004 Domestic Retum Receipt 102595-02-M-1540 <br />