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COMPLETE •N COMPLETE THIS SECTION ON DELIVEPY <br /> ■ Complete items 1,2,and 3.Also complete A. Signature <br /> item 4 if ❑Agent <br /> ■ Print yo d o t reverse X -� ❑Addressee <br /> so that a u. B. Received by(Printed Name) C. Date of Delivery <br /> ■ Attach this card to the back o the mailpiece, <br /> or on the front if space permits. <br /> D. Is delivery address different from item 1? El Yes <br /> 1. Article Addressed to: If YES,enter delivery address below: ❑No <br /> PACIFIC MINI MART &DELI & <br /> GAS'- <br /> 4511 PACIFIC AVE <br /> STOCKTON CA 95207 3. Service Type <br /> 4 Certified Mail ❑Express Mail <br /> Registered ❑Return Receipt for Merchandise <br /> ❑Insured Mail ❑C.O.D. <br /> 4. Restricted Delivery?(Extra Fee) ❑Yes <br /> 2. Article Number 7004 2512 0003 3789 2142 <br /> (Transfer from service label) <br /> PS Form 3811,February 2004 Domestic Return Receipt 102595-02-M-1540 <br />