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■ Complete items 1, 2, and 3. Also complete <br />item 4 if Rl <br />■ Print your d e verse <br />so that we h c <br />■ Attach this card to the back of the mailpiece, <br />or on the front if space permits. <br />1. Article Addressed to: <br />PACIFIC BELL <br />10 E 12TH ST <br />TRACY CA 95376 <br />A. Signature /. <br />❑ Agent <br />X Jfq&� . 40 <br />Addre <br />B. ReKeived by(Printed Name) I C. fete yf Del <br />D. Is delivery address different from item 1? Y� es <br />If YES, enter delivery address below: ❑ No <br />1. Service Type <br />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 2510 0003 3789 1044 <br />(Transfer from service labeq <br />IPS Form 3811, February 2004 Domestic Return Receipt 102595-02-M-1540 <br />