CE 141 Jasmine St 2013 COMPLETE •
■ Complete items 1,2,and 3.Also complete A. Si ure
item 4 if Restricted Delivery is desired. r /
■ Print your name and address on the reverse G El Agent
so that we can return the card to you. Addressee
■ Attach this card to the back of the mailpiece, ei Printed Name) C. Date of Delivery
or on the front if space permits. _ R� --
1. Article Addressed to: D. Is delivery address different from item 1? 0 Yes
rIf YES,enter delivery ageess.below: 0 No
W C Lmri -Si1cK(,00 �1
// / EEH 1 F 7111?
/T''l"Zq-5'w I JI:--- S7-. 3. Service Type
0 Certified Mail ❑Express
0 Registered ❑Return R for Merchandise
Cast O Insured Mail 1:1C.O.D.
4. Restricted Delivery?(Extra Fee) 0 Yes
2. Article Number
(transfer from service label) 7 010 1870 0002 0629 5235
PS Form 3811, February 2004 Domestic Return Receipt
102595-02-M-1540
UNITED STATES POSTAL SERVICE
First-Class Mail
Postage&Fees Paid
USPS
Permit No. G-10
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Sender: Please print your name, address, and ZIP+4 in this box
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CITY OF ATLANTIC BEACH
800 SEMINOLE ROAD
ATLANTIC BEACH,FLORIDA 32233
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