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2011-07-05_REVISION - C1994082
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2011-07-05_REVISION - C1994082
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Entry Properties
Last modified
8/24/2016 4:35:21 PM
Creation date
7/11/2011 10:39:11 AM
Metadata
Fields
Template:
DRMS Permit Index
Permit No
C1994082
IBM Index Class Name
REVISION
Doc Date
7/5/2011
Doc Name
Certified Return Receipt (Inspection Notification)
From
John W and Linda Patrick
To
DRMS
Type & Sequence
SL3
Email Name
SLB
SB1
Media Type
D
Archive
No
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' SENDER: <br />o ■ Complete items 1 and/or 2 for additional services. <br />• Complete items 3, 4a, and 4b. <br />w ■ Print your name and address on the reverse of this form so that we can return this <br />d card to you. <br />•Attach this form to the front of the mailpiece, or on the back if space does not <br />permit. <br />, ■ Write'Retum Receipt Requested' on the mailpiece below the article number. <br />. <br />•The Return Receipt will show to whom the article was delivered and the date <br />• delivered. <br />0 <br />3. Article Addressed to: <br />a <br />E <br />John W. and Linda Patrick <br />• 16038 Clover Lane <br />cc <br />o Dubuque, IA 52002 <br />cc <br />z <br />5. Received By: (Print Name) <br />cc <br />6. Sign e: (Addres Agent) <br />_ '' X a:mm.e..a, <br />PS Form 3811, December 1994 <br />7008 3230 <br />4b. Service Type <br />❑ Registered <br />❑ Express Mail <br />I also wish to receive the <br />following services (for an <br />extra fee): <br />1. ❑ Addressee's Address <br />2. ❑ Restricted Delivery <br />Consult postmaster for fee. <br />0002 7252 5981 cc <br />cc <br />a <br />❑ Certified <br />❑ Insured <br />❑ Return Receipt for Merchandise ❑ COD <br />7. Date of Deli <br />8. Addressee's A d�r (Oily if requested <br />and fee is paid) <br />Domestic Return Receipt <br />L(qqq-Ow2 <br />SL -3 <br />1„8 <br />aco2 <br />L-Th( <br />0 <br />• <br />ar <br />to <br />a <br />U <br />
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