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.. <br />N <br />Lri ~ ~ <br />m .• <br />m <br /> D~-tF3~~~" r '~'"` ~ <br /> ~ <br />~, <br />p <br />Cerltlkd Fee ~) <br />t_J/t~ <br />7 <br />S <br />d _ <br />P ~ `t <br />p Realm Redept Fee <br />(F1Mareemenl Required) <br />.~, s <br />~~ ., <br />p`1 ~,_ <br />p <br />7 Rea0lcted Delivery Fee <br />(rstldeerrieM RxrykeA) , S <br />j i O0 ~, ~ 1. <br />11 <br />i <br />A <br />n.l <br />Total Paeta <br />e 8 Fees $ ` <br />~. ~~ .Y~ `_ <br />p^, <br />2~~ . ~~ <br /> B <br />,•. dr 9~ <br />rU <br />p <br />l~zs!ei..- <br />A <br />N <br />S . <br />~ <br />r <br /> a; <br />bee4 <br />vc <br /> ,,.arr a,,.u~. .. _..__ <br /> <br />^ Complete items 1, 2, and 3. Also complete <br />item 4 if Restrictetl Delivery is tlesired. <br />^ Print your name and address on the reverse <br />so that we can return the card to you. <br />^ Attach this card to the back of the mailpiece, <br />or on the front if space permits. <br />A. <br /> <br />^ Agent <br />^ Adtlre <br />1. Article Atltlressed to <br />Western States Crop Insurance <br />17412 E. Louis Avenue <br />Escalon, CA 95320 <br />B.'Received by (Printed Name) C. Date of Delive <br />a~- <br />D. Is delivery address tlifferent from item 17 ^ Yes <br />If YES, enter delivery address below: ^ No <br />3. Service Type <br />p Certified Mail ^ Express Mail <br />^ Registered ^ Return Receipt for Merchandise <br />^ Insured Mail ^ C.O.D. <br />4. Restdcted Delivery? (Extra Feel ^ Ves <br />2. Article Number <br />(rransrer rrom service label) 7 0 0 2 2 410 0 0 0 5 914 5 8 3 5 2 <br />PS Form 3811. August 2001 Domestic Retum Receipt 102595-02-M-1560' <br />