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1 <br />23201 S. SANTA FE ROAD ar.�: L47-�VV'1J <br />SEN® F; I also vAel—l- recel <br />9 ■cqn ms f aridtor 2'�di6onal �� following ices or an <br />i a ■cqn ms 3, 4a, and s <br />® <br />■Print address on the reverse of this form so that we can retw extra fee} <br />card to you. <br />■Attach this form to the front of the mailpiece, or on the back it specs does not 1 • ❑Addressee's Address <br />n <br />® <br />■ W Aetum Receipt Requested' ort the mailpiece below the article number. 2. 13 Restricted Delivery <br />the article was delivered and the date <br />N <br />. <br />■The Return Receipt will show to whom <br />Consult postmaster for fee. <br />04a• <br />delivered. <br />Article Number <br />3. Article Addressed to: <br />r; <br />Z 228 988 997 <br />c, <br />4b. Service Type <br />E <br />BILL LANE ❑ Registered ®Certified <br />Co <br />23125 S. HENRY ROAD ❑ Express Mail ®Insured <br />RIVERBANK, CA 95320 ❑ Retum Receipt for Merchandise ❑ COD <br />c <br />7. Date of Delivery <br />- <br />0 <br />A <br />8. Addressee's Address (only if requested <br />c <br />5. Received By: (Print Name) <br />and fee is paid) <br />0 <br />3 <br />6. ign lure: (Addressee or Agent) <br />0 <br />' x-- \ r Domestic Return Receipt <br />PS Form 3811, December 1994 <br />1 <br />