116 LAFAYETTE STREET UNIT 202 RETURNED CERTIFIED MAIL CARD 6-9-2025 c6MPLETE THIS SECTION • • ON DELIVERY
■ Complete items 1,2,and 3. A. Signaturez;+X _.;
■ Print.your name and address on the reverse ❑Agent
so that we can return the card to you. X L— ❑Addressee
■ Attach this card to the back of the mailpiece, B.Receive (Printed Name) C. Date of Delivery
or on the front if space permits. 0 N 0 1 +f(A1 I bJ,, Q`312
1. Article Addressed to: D. Is delivery address different from item 1? ❑Yes
4�// L L C If YES,enter delivery address below: p No
G t'F� Cf0►rgS i
321- Font.,)( S+rce+
II I II'I�I I II I'I I I�II I I I(I I I I I II I I I II��III I III 3. Service Type ❑Priority Mail Express@
❑❑Adult Signature. Registered MailaiITMT"'
❑Adult Signature Restricted Delivery ❑Registered Mail Restrictet
)(Certified Maile Delivery
9590 9402 8704 3310 7014 79 ❑Certified Mail Restricted Delivery ❑Signature Confirmation*^+
❑Collect on Delivery ❑Signature Confirmation
2. Article Number/Transfer from.cerviee r r,an ❑Collect on Delivery Restricted Delivery Restricted Delivery
Mail
9569 0 710 5 2 7 0 3103 1125 7 8 Mail Restricted Delivery
kavur 4,600)
PS Form 3811,July 2020 PSN 7530-02-000-9053 Domestic Return Receipt
USPS TRACKWG# — - -
First-Class Mail
Postage&Fees Paid
Q USPS
Permit No.G-10
11 t
3L
9590 9402 8704 3310 7014 79
United States •Sender: Please print your name,address,and ZIP+4®in this box•
Postal Service
RECEIVED & CITY
OF SALEM
BOARD OF HEALTH
JUN 0 S 2125 SALEM,AGTON O 970 T,31ZD FL
CITY OF SAL M
BOARD OF HE