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2005-09-21_REVISION - M1977493 (3)
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2005-09-21_REVISION - M1977493 (3)
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Last modified
6/15/2021 5:45:55 PM
Creation date
11/1/2011 7:29:06 AM
Metadata
Fields
Template:
DRMS Permit Index
Permit No
M1977493
IBM Index Class Name
REVISION
Doc Date
9/21/2005
Doc Name
Documentation of Notices to Parties within 200'
From
Climax
To
DMG
Type & Sequence
AM5
Media Type
D
Archive
No
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E NDER COMPLETE THIS SECTI <br />2. Article Number <br />(Transfer from service label) <br />COMPLETE'THIS SECTION ON DEL/VERY <br />B. Fteceiv y' ( Printed Name) <br />/ /Il <br />` J <br />• Complete items 1, 2, and 3. Also complete <br />item 4 if Restricted Delivery is desired. <br />M 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 />1. Article Addressed to: <br />gt_e >D ,mss_ 6. <br />'t6 Aer <br />6 Wee S <br />/f s"` t1;e44•L„ <br />PS Form 3811, February 2004 <br />le Complete items 1, 2, and 3. Also complete <br />item 4 if Restricted Delivery is desired. <br />Is 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 />1. Article Addressed to: <br />2. Article Number <br />(Transfer from service label) <br />2. Article Number <br />(Transfer from service label) <br />PS Form 3811, February 2004 <br />® Complete items 1, 2, and 3. Also complete <br />item 4 if Restricted Delivery is desired. <br />M 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 />1. Article Addressed to: <br />n 4 / <br />V 2, , z -, <br />d7i 4 <br />k� <br />PS Form 3811, February 2004 <br />Domestic Return Receipt <br />Domestic Return Receipt <br />Domestic Return Receipt <br />D. Is delivery address different from item 1? ❑ Yes <br />If YES, enter delivery address below: ❑ No <br />3. Service Type <br />el Mail <br />❑ Registered <br />❑ Insured Mail <br />4. Restricted Delivery? (Extra Fee) <br />A. Signature <br />x <br />7004 0750 0001 7943 4647 <br />3. Service Type <br />❑-eertified Mail <br />❑ Registered <br />❑ insured Mail <br />4. Restricted Delivery? (Extra Fee) <br />7004 0750 0001 7943 4593 <br />❑ Agent <br />❑ Address <br />C. Date of Delive <br />❑ Express Mail <br />Q-Retum Receipt for Merohandil <br />❑ C.O.D. <br />SENDER:' COMPLETE THIS SECTION is <br />COMPLETE THIS SECTION ON DELIVERY <br />B. Received by ( Printed Name) <br />elive <br />D. Is delivery address different from item ? /A Yes <br />If YES, enter, delivery address below: ❑ No <br />3. Service Type <br />-E C r rtified Mail ❑ Mail <br />❑ Registered eturn Receipt for Merchandi: <br />❑ Insured Mail ❑ C.O.D. <br />4. Restricted Delivery? (Extra Fee) ❑ Yes <br />SENDER THIS SECTION °; <br />❑ Yes <br />102595 -02 - M - lt <br />❑ Agent <br />❑ Ad <br />102595 - 02 - M - 15 <br />I, Agent <br />0 Address( <br />D. Is delivery address different from item 1? ❑ Yes <br />If YES, enter delivery address below: ❑ No <br />❑'Express Mail <br />la- Return Receipt for Merchandise <br />❑ C.O.D. <br />0 Yes <br />102595-02 -M -154 <br />
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