116 LAFAYETTE STREET UNIT 202 RETURNED CERTIFIED MAIL CARD 3-17-2025 SENDER: COMPLETE THIS SECTION COMPLETE THIS SECTION ON DELIVERY
■ Complete items 1,2,and 3. A. Signatu •��
■ Print your nartie„and address on the reverse E3 Agent
so that we can return the card to you. ❑Addressee
■ Attach this card to the back of the mailpiece, tgdblved by(Printed Name) C. Date of Delivery
or on the front if space permits.
1. Article Addressed to: D is delivery address different from item 1? ❑Yes
L4' If YES,enter delivery address below: ❑No
311 I�++�,toms LAC s��-r
�I I�illl III I�I I II II I I I I II I�I I I I II II IIII III 3. Service Type ❑Priority Mail Express;-
0 Adult Signature ❑Registered MajlTM
❑Adult Signature Restricted Delivery ❑Registered Mail Restrictec
Certified Mail® Delivery
9590 9402 8704 3310 7005 40 ❑Certified Mail Restricted Delivery ❑Signature Confirmation*^'
❑Collect on Delivery ❑Signature Confirmation
2. Article Number(transfer from service label) ❑Collect on Delivery Restricted Delivery Restricted Delivery
Mail
9589 0 710 5270 0283 0 5 4 0 01 Mall Restricted Delivery
00
PS Form 3811,July 2020 PSN 7530-02-000-9053 Domestic Return Receipt
USPS TRACKING#
First-Class Mail
no Postage&Fees Paid
111 USPS
.� L Permit No.G-10
9590 9402 8704 3310 7005 40,
United States •Sender:Please print your name,address,and ZIP+4®in this box•
Postal Service
RECEIVED
CITY OF SALEM
BOARD OF HEALTH
MAR 17 20 5 • * 98 WASHINGTON ST,3RD FL
SALEM,MA 01970
CITY OF SALE
BOARD OF HEM TH
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