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^ I a1 0 1 t ceive the <br /> •N Comple a items 1 and/or 2 for additional services, following services or an extra <br /> • Complete items 3, and 4a&b• feel: SEP 1 9 <br /> Hreverse of this orm so that can <br /> • Print your name and address on the we <br /> m return this card to you. 1. ❑ Addressee's Address y <br /> 7 • Attach this form to the front of the mailpiece,ar on the back it space a <br /> does not permit. p, ❑ Restricted Delivery y <br /> C d Write"Return Receipt Requested"on the mailpiece below the article number. <br /> QThe Return Receipt will show to whom the article was delivered and the date Consult ostmaster for fee. emc <br /> ..4 C c delivered. 4a. Article Number e <br /> Q g. Article Addressed to: P 298 9 9 9 8 6 0 <br /> o.., - WALT DEN DULK 4b. Service Type <br /> cr r_RIPON MILLING ❑ Registered ❑ insured <br /> o ❑ COD <br /> P O BOK 180 Certified w <br /> 95336 ❑ Express Mail ❑ Return Receipt for <br /> d'� g RIPON CA Merchandise o <br /> Iv a 7. o f o� <br /> `C o <br /> a <br /> CL Q <br /> 8. Addre:se ld'dress (Only if requested 5 <br /> Z 5 i ature (Ad r ssee) and fee <br /> L <br /> H <br /> Lu g, 'g ature (Agent) <br /> T PS dorm 3811, December 1991 irU.s.GP0:1993-3527i4 DOMESTIC RETURN RECEIPT <br />