SENDER : COMPLETE THIS SECTION

I ∎ Complete Items 1, 2, and 3 . Also complete

I

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,

1

or on the front if space permits .

1 . Article Addressed to:

1/26/07

B .M.

PCB 2006-150

Christine G . Zeman

Hodge Dwyer Zeman

3150 Roland Avenue

Post Office Box 5776

Springfield, IL 62705-5776

I

1 2

. Article Number

QRIGINIQ J

COMPLETE THIS SECTION ON DELIVERY

A. Signs

X

0 Agent

OAddressee

8 . R ived by (Printed Name)

C. Date of Delivery

Ir7,0 1,ee

0

. Is delivery address different from item 1? O

Yes

If YES, enter delivery address below:

0 No

3. Se ceType

riffled Mail 0 Express Mail

0 Registered

0 Return Receipt for Merchandise

0 Insured mail

0 C.O.D .

4. Restricted Delivery? (Extra Fee)

13 Yes

(Transferhnmservice labe!) 7001 1140 0002

7469 0695

PS

Form 3811, February 2004

Domestic Return Receipt

702595-02-M-1540 I

REC~=gi,fFDCLERK'S

OFFICE