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SECTIONSENDER: COMPLETE THIS SECTION COMPLETE THIS ON DELIVERY <br /> ■ Complete items 1,2,and 3.Also complete A. Sig / <br /> item 4 if RellrifftX Agent <br /> ■ Print your verse /� Addressee <br /> so that we lot B. eceived by(Printed Name) C. ate Deliv ry <br /> ■ Attach this card to the back of the mailpiece, i ` - , D <br /> or on the front if space permits. <br /> D. Is delivery address different from item 1? Y <br /> 1. Article Addressed to: If YES,enter delivery address below: ❑No <br /> NICKS BP* #2611195 <br /> 16500 E LOUISE AVE <br /> LATHROP CA 95330 3. Service Type <br /> Certified Mail 13 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 <br /> (rransfer from service label) 7004 2 510 0003 3 7 8 9 1723 <br /> PS Form 3811,February 2004 Domestic Return Receipt 102595-o2-M-1540 <br />