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f Z 128 784 100 <br /> Qceio <br /> stal Service .� <br /> Viol - f for <br /> rCertified Mat! - -- <br /> No Insurance Coverage Provided. <br /> Do not use for International Mail See reverse-). <br /> Sent to t <br /> " Street&-Number - <br /> Post Office,State,&ZIP Code. _ <br /> r <br /> Postage $ <br /> co <br /> Z slivery F <br /> r <br /> Ln <br /> rn I Return It Showing <br /> tr <br /> Whom& to IN red ' <br /> ici Aetum Re;W to 4Ylrom, <br /> Q Date,&Aft . -� <br /> *` 0 TOTAL.P stag & $ �- <br /> Postmark or 7!F'7 <br /> ti <br /> t <br /> HANSEN` <br /> .Cort�plete ile '. .ARCTIC ICE g t !r' r: eive the <br /> a ■Completb Re 3 and } r . <br /> ■Print your name and adds on th 1!626 6261 -KIMBERLY LN a )s(for an r <br /> �"d to you STOCKTON CA 95212-91 k , <br /> x�Attach this form to the trout .. «. s V #�T y«vF +#M.S 4". Cr -i ee s7 dress I + <br /> pennit� <br /> Write Return Receipt Requested"_..�:n=" �, unr, u.rzoaunadd Delivery <br /> ■The Retum Receipt will show to whom the aAcso was delivered and the date <br /> delivered. Consult postmaster for fee. ,- <br /> 3.Article Addressed to: 4a.Articl u ber <br /> LEE HANSEN �� <br /> ARCTIC ICE 4b.Service Type E <br /> y 6261 KIMBERLY LN ❑ Registered St, <br /> Mad <br /> ❑ Express Mail red c <br /> STOCKTON CA 95212-9427 ❑ Return Receipt for Merchandise ❑ COD <br /> 7.Date of Delivery r1 913 <br /> I t <br /> ' <br /> 5-S 6ceived By: (Print Name) 8.Addressee's Address(Only if requested <br /> Y ' <br /> and fee is pa' tC <br /> 6.S1 <br /> °0 PS Forrnl .ipt <br />