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<br />P 289 635 594 <br /> <br />US Postal Service <br />Receipt for Certified Mail <br />No Insurance Coverage Provided. <br />Do not use for Intemational Mail See reverse <br />Sent to <br />Ms. Sandra Salazar <br />Street & Number <br />7336 Old Mill Road <br />Post Office, Stale, & ZIP Code <br />C . <br /> <br /> <br />Postage <br /> <br />$ <br /> <br />.33 <br />1.24 <br /> <br />Certified Fee <br /> <br />Special Delivery Fee <br /> <br />Restricted Delivery Fee <br /> <br />LO <br />~ Retum Receipt Showing to <br />Whom & Date Delivered <br />~ Return Receipt Showing to Whom, <br />c( Date, & Addressee's Address <br />ci <br />o TOTAL Postage & Fees $ <br />CIO <br />CO) Postmark or Date <br />E <br />o <br />u.. <br />en <br />a... <br /> <br />~ <br /> <br />Fold at line over top of envelope to <br />the right of the return address <br /> <br />.,. <br /> <br />T <br /> <br />-1 <br />ent <br />~~ <br /> <br />C'- <br />II <br />"C <br />iii <br />II <br />III <br />... <br />II <br />> <br />II <br />... <br />II <br />.s:. <br />- <br />c <br />o <br />"C <br />II <br />i <br />ii <br />E <br />o <br />u <br />en <br /> <br />SENDER: I also wish to receive the <br />- Complete items 1 and/or 2 for additional services. <br />-Complete items 3, 4a, and 4b. following services (for an <br />- Print your name and address on the reverse of this form so that we can return this extra fee): <br />card to you. <br />- Attach this form to the front of the mailpiece, or on the back if space does not 1. 0 Addressee's Address <br />permit. 2. 10 Restricted Delivery <br />-Write'Rerum Receipr Requesred' on the maiJpiece below the article number. <br />- The Retum Receipt will show to whom the article was delivered and the date <br />delivered. Consult postmaster for fee. <br />3. Article Addressed to: 4a. Article Number <br />Ms. Sandra Salazar P 289 635 594 <br />7336 Old Mill Road 4b. Service Type <br />Centerville, MN 55038 o Registered IX Certified <br /> o Express Mail o Insured <br /> IX Retum Receipt for Merchandise o COD <br /> 7. Date of Delivery <br />5. Received By: (Print Name) 8. Addressee's Address (Only if requested <br /> and fee is paid) <br />6. Signature: (Addressee or Agent) <br />X <br /> <br />Street · <br /> <br /> <br />... <br />j <br />o <br />>- <br />.!! <br />PS Fonm 3811, December 1994 <br /> <br />Domestic Return Receipt <br /> <br />.,. <br /> <br />CIi <br />u <br />'~ <br />II <br />en <br />Q. <br />'Qj <br />U <br />II <br />a: <br />c <br />... <br />:) <br />Gl <br />a: <br />01 <br />c: <br />'iij <br />j <br />.E <br /> <br />:) <br />o <br />>- <br />~ <br />C <br />l'lI <br />.s:. <br />~ <br />