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2009-11-16_REVISION - C1984067 (4)
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2009-11-16_REVISION - C1984067 (4)
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Entry Properties
Last modified
8/24/2016 3:57:00 PM
Creation date
11/24/2009 2:58:21 PM
Metadata
Fields
Template:
DRMS Permit Index
Permit No
C1984067
IBM Index Class Name
REVISION
Doc Date
11/16/2009
Doc Name
Certified Mail Receipt (Termination of Jurisidiction)
From
Robert & Jean Gonzalez
To
DRMS
Type & Sequence
SL1
Email Name
TAK
Media Type
D
Archive
No
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C q Lj- () � <br />- TU - 3 <br />SLA <br />TAK <br />U.S. postal Service-rm <br />CERTIFIED MAILT.RECEIPT <br />Er nce C provided) <br />M (Do ti Mail Only; No Insura es <br />1 ru <br />$0.44: <br />t <br />n postage* $iii <br />j� � <br />Certified Fee: /$ � �stm <br />Cer <br />c t Fee: l? He <br />c Return Receipt <br />$5.54:. ` t <br />c Fees: <br />u- Total postage & ,. <br />M <br />Total Postage & Fees <br />►.r1 — <br />17 nt <br />°�E Rober R River Tree Circle Gon zalez ::�: -�: �:-::::-- <br />or PC 253 T. <br />Q1 " Sanford FL, 32771 -83 <br />■ Complete items 1, 2, and 3. Also complete <br />Item 4 if Restricted Delivery Is desired. <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 Signature <br />X 1y z <br />Agent <br />1. Article Addressed to: <br />Robert T. Jean W. Gonzalez <br />2535 River Tree Circle <br />Sanford FL 32771 -8334 <br />B. 636ceived b0PAnted Name) (C .mate of Delivery <br />•C�04 ( 12z 1 11 —tc. - O <br />D. Is delivery address different from item 1? 0 Yes <br />If YES, enter delivery address below: 2K No <br />Service Type <br />O certined Mail O Express Mall <br />0 Registered 0 Return Receipt for Merchandise <br />0 Insured Mail 0 C.O.D. <br />4. Restricted Delivery? (Extra Fee) 0 Yes <br />2. Article Number 7005 0390 0002 8281 8397 <br />(Transfer from service label) <br />PS Form 3811, February 2004 Domestic Return Receipt 102595.02 -M -1540 <br />
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