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COMPLETE •N COMPLETE THIS SECTIONON DELIVERY <br /> ■ Complete items 1,2,and 3.Also co ete A. Si nature_ / <br /> item 4 if Restricted v L7 Agent <br /> ■ Print your name anrseX ❑.Addressee <br /> so that we can retu ar%,'et=h <br /> o0 <br /> y u. .�Recel by(Printed Name ate of Delivery <br /> ■ Attach this card to the back of the mail I ��a� I <br /> or on the front if space permits. OMI w <br /> ry address different from item 1? ❑`Fas <br /> 1. Article Addressed to: ILill <br /> If YES,enter delivery address below: ❑ No i <br /> KIM HERNANDEZ DEC 2013 <br /> HALEY FARMS <br /> PO BOX 576218 ENVIRONME AL'�1FALTI-I <br /> MODESTO CA 93357 PERMITI• 3. ervlceType <br /> ACertified Mail ❑Express Mail <br /> ❑Registered ❑Return Receipt for Merchandise <br /> _•b Insured Mail ❑C.O.D. <br /> 4. Restricted Delivery?(Extra Fee) ❑Yes <br /> 2. Article Number 7 010 2780 0 0 0 0 6640 1 0 31 <br /> (transfer from service label) <br /> PS Form 3811,February 2004 Domestic Retum Receipt 102595-02-M-1540 <br />