RECEIVED

CLERK’S OFFICE

SEP 15

2004

STATE OF ILLINOIS

~~~POjI~tj~~ControjBoard

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.

• Attach this card to the back of the mailpiece,

or on the front if space permits~

1. ArticleAddressedto: 9/2/04 B.M.

PCB 2005—042

Chris &

GT~gg

Niebrugge

Dietrich,tft

62424

3. Service Type

o Certifled Mail

C Registered

o Insured Mail

4. Restricted Delivery?

(Eiifra Fee)

0 Yes

~2c~’2y

o Express. Mail

O Return Receipt for Mercta~idise

o CO.D.

V

D.. Is delivery address .different’from Item 1?

If YES, enter delivery address below: / 0 No

/~. &C

Zc(L

2.

Alticle Number

I

(Thansferfromservlce (abel)

7004 1160 0005 4123 1553

PS Form 3811, February 2004

Domestic Return, Receipt

10259502:M1540