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J <br />3 <br />Sf.VOGII: (nmPlelr Item 1 •red ). <br />Add P , addms in the "RETURN TO" (pate on <br />revere. <br />I. The following service it requested (check one). <br />Show to whom and date delivered............ 15Y <br />Show to whom, d..te, S: address of delivery.. 350 <br />DELIVER ON:Y 1.0 ADDRESSEE and <br />show to whom and date delivered............ 65F <br />DELIVER ONLY TO ADDRESSEE and <br />show to whom, date, and address of <br />delivery..... .............. ............................ 650 <br />2. ARTICLE ADDRESSED TO: <br />Jim Medford <br />1621 63rd Street <br />Everett, Washington 98203 <br />3. ARTICLE DESCRIPTION: <br />RdGISTERED NO. CERTIFIED NO. INSURED NO. <br />I 581456 <br />(Always obtain signsture of addressee or agent) <br />I have received the article described above. <br />SIGNATURE <br />4. <br />OF DELIVERY <br />POSTMARK <br />S. ADDRESS (Complete will, It requested) <br />6. UNABLE TO DELIVER BECAUSE: <br />CLERN'9 <br />INITIALS <br />. am : IOt O • 921• IN <br />li"ut-li'I FOR CERTIFIED MAIL-30,_ (p)us postage) <br />POSTMARK <br />Jim Medford OR DATE <br />1621 63rd Street <br />Everett, Wa. 98203 <br />�iL <br />r.1111Nh ..i GPI iI. lit 111, <br />(.1� <br />XIWin <br />Rt[I lfl ] SLan IG •rum, drtr area .here deleted <br />JSf5r <br />SCFYICIS wn. r�.ln�. Pinneq <br />a5( <br />,. .. IP ql..i ui <br />Ps lurm 0000 NO INSURANCE COVERAGE PROVIOEO— (S., othe, nd.) <br />A114 191!s NOT FOR INURNATIONAL MAIL <br />