4903_Green Card_20210115

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Complete items 1, 2, and 3.
I Print your name and address on the reverse
so that we can return the card to you.
i Attach this card to the back of the mailpiece,
MIS. Beth .jc)ne5, COUrlty Manager
PO Box 788
Statesville, PVC 28681
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A. Signatur
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B. Receive by (Pri
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D. Is deliveryaddress different from item 1 ? ❑ Yes
If YES, enter ' address below: ❑ No
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JAN 2 8 2021
3. Service T e '"
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Adult Signature ❑ Registered Mai ITM
❑ Adult Signature Restricted Delivery ❑ Registered Mail Restric
❑ Certified Mail® Delivery
9590 9402 5027 9063 9619 69 ❑ Certified Mail Restricted Delivery ® Return Receipt for
❑ Collect on Delivery Merchandise
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7017 2620 0000 6788 9472 ail El Signature Confirmation
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S Form 3811, July 2015 PSN 7530-02-000-9053 Domestic Return Receir
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Ms. Beth .!ones;, County Manager
PO Roy 7PQ
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