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COMPLETE • • •ELIVERY <br /> LO • SECTION <br /> v <br /> A. Signature <br /> ■ Complete items 1,2,and 3. ❑ Agent <br /> co <br /> ■ Print your name and address on the reverse X C3 Addressee <br /> so that we can return the card to you. i Name) C. Date of Delivery <br /> ■ Attachis card to the back of the mailpiece <br /> or on Me front if space permits. <br /> . Article Addressed to: D. Is delivery address different from item 1? ❑Yes <br /> 1 <br /> _ P IfaEj,¢MVelivery address below: C] No <br /> TI00tHY W&RACHAEL HIGGINS TR FA0021507 . [��JJ'' <br /> 766 CH .TAVE ENVII NMENTALHEALTH <br /> SAN BR ` A 54066 <br /> P W/SERVICDO <br /> PRG BLL, QTR 2016 NIT II-H <br /> RE 4105 E: CTION AVE.,STKN <br /> 3. Service Type 0 Priority Mail Express® <br /> 0 Adult Signature 0 Registered Mail'" <br /> II I'lIl'l I'll I'I II II I�I ll I�I II I I II II I'II'I I'll 0 Adult Signature Restricted Delivery ❑Registered Mail Restricted <br /> ertified MailODeliveryeturn Receipt for <br /> El Certified Mail Restricted Delivery Merchandise <br /> 9590 9401 0058 5071 6134 52 OCollect onDelivery OMerchandise Signature Confirmation'" <br /> 0 Collect on Delivery Restricted Delivery 0 Signature Confirmation <br /> n n.�i,io nig iml,or!Transfer from service label) -- --�"tail Restricted Delivery <br /> 7 015 0640 0007 11,18 7802 0) Restricted Delivery <br /> Domestic Return Receipt <br /> PS Form 3811,April 2015 PSN 7530-02-000-9053 <br />