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COMPLETE THIS <br /> ELIVERy <br /> ■ Complete items 1,2, and 3.Also complete IA. Signature SECTION ON <br /> , <br /> item 4 if Restricted Delivery is desired. <br /> ■ Print your name and address on the reverse X <br /> so that we can return the card to you. Agent <br /> ■ Attach this card to the back of the mailpiece, Addressee <br /> 6 <br /> or on the front if space permits. B. Received by(Printed Name) C. Date of Delivery <br /> 1. Article Addressed to: <br /> D. Is delivery address different frpuFjt 1 ll <br /> If YES,enter delivery addre ' <br /> RICHARD J KOOISTRA <br /> 1523 W RUTLEDGE WAY <br /> STOCKTON CA 95207 r NJ <br /> RES 9-21-05 3. Service Type nCr� <br /> Certified Mail ❑ <br /> RE 1523 W RUTLEDGE WAY,STKI Express Mail r Lnwll, y <br /> Registered ❑Return Receipt for Merchandise <br /> ❑Insured Mail ❑C.O.D. <br /> 4. Restricted Delivery?(Extra Fee) <br /> 2. Article Number ❑ Yes <br /> (Transfer Irom service label) 7004 251,0 0 0 1-13 39 4 5 91 12 <br /> PS Form 3811, February 2004 <br /> Domestic Return Receipt <br /> 102595-02-M-1540 <br />