CE 275 SAILFISH DR 2013 s)
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CASE ACTION FORM
Investigation# DATE:
NAME:
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ADDRESS OF VIOLATION 73—
Action Taken:
I if
Compliance:
• Complete items 1,2,and 3.Also complete A. •
item 4 if Restricted DeliveryS
■ Print your name and address on the reverse X tum
so that we can return the card to � �i C_____
■ Attach this card to the back of the you. �. 13 Agent
or on the front ifs mailpiece, celved by(punt Addressee
pace permits. Q el All l 1` , C. Date of elivery
1. Article Addressed to:
D. Is delivery address different from it
If YES,enter delive m t? Yes
ry addre
s
SAPR 112013 p
3. a TYPe =�.
Certified Mail ❑ Mail
/.5— Registered
O Return Receipt f�
❑ ❑C. .
Insured Mail P Merchandise
OD.
2. Article Number 4. Restricted Delivery?(pxra Fee)
(Transfer from service 7 011 0 Yes
PS Form 3811, February 2004 2000 0002 0346 7722
Domestic Return Receipt
102595-02-M-1540;