CLERK’S

OFFICE

SEP’

22OO8

STATE

OF

ILLINOIS

POI1tjo

Control

Board

SENDER:

COMPLETE

THIS

SECTION

COMPLETE

THIS

SECTION

ON

DELIVERY

•

Complete

items

1,

2,

and

3.

Also

complete

A.

Signature

ID

Agent

item

4

if

Restricted

Delivery

is

desired.

X

C

Addressee

B

Print

your

name

and

address

on

the

reverse

so

that

we

can

return

the

card

to

you.

B.

Received

byt’PrintedName)

0._Date

of

Delivery

B

Attach

this

card

to

the

back

of

the

mailpiece,

I

-

-

or

on

the

front

if

space

permits.

D.

Is

deilvery

tdress

different

fr6m

item

1?

0

Yes

If

YES,

enter

delivery

address

below:

ID

No

1.

Article

Addressed

to:

9/16/08

B

AC.,,

2008—034

Joph

Combs

260

Isreal

Street

White

Hall,

IL

62092

3.

Service

Type

‘Certifled

Mail

ID

Express

Mail

ID

Registered

ID

Return

Receipt

for

Merchandise

C

Insured

Mail

C

G.O.D.

4.

Restricted

Delivery?

(Extra

Fee)

ID

Yes

2.

Article

Number

(Transferfrom

sen’ice

label)

7007

3020

0000

4630

7313

PS

Form

381

t,

February

2004

Domestic

Return

Receipt

102595-02-M-1540