SENDER:
    COMPLETE
    THIS
    SECTION
    Complete
    items
    1, 2,
    and
    3. Also
    complete
    item
    4 if
    Restricted
    Delivery
    is
    desired.
    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,
    or
    on
    the
    front
    if
    space
    permits.
    1.
    Article
    Addressed
    to:
    9/16/08
    B
    .M.
    PCB
    2009—015
    Brandon
    Laf
    ever
    1788
    80th
    Street
    Illinois
    City,
    IL
    61259
    ECDVED
    CLERK’S
    OFFICE
    STATE
    OF
    ILLINOIS
    PoIIuton Control
    Board
    Agent
    E] Addressee
    Date
    of
    Delivery
    • D. Is
    dIiveiy
    address
    different
    fiom
    item
    1?
    []
    Yes
    If YES,
    enter
    delivery
    address
    below:
    No
    I
    3. Service
    Type
    Certifled
    Mail
    D
    Express
    Mail
    D
    Registered
    El
    Return
    Receipt
    for
    Merchandise
    El
    Insured
    Mail
    El C.O.D.
    4.
    Restricted
    Delivery?
    (Ectra
    Fee)
    El
    Yes
    2
    Article
    Number
    (rransferfromse,v!celabel)
    7007
    30200000
    4630
    7436
    PS
    Form
    3811,
    February
    2004
    Domestic
    Return
    Receipt
    102595-02-M-1540

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