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 . Article Addressed to

: 5/3/07 B .M .

AC 2004-051

Michael Moreton

P .O . box 309

Ashmore, IL 61912

2. Article Number

(Transfer from service iabel)

7006 0100 0000

7374 7781

PS Form

3811, February 2004

Domestic Return Receipt

COMPLETE THIS SECTION ON DELIVERY

A. Signature

erved by (Printed

Name)

C. Date Deli

0~

ry

;

Is delNery address different from item 17

0 Yes

If YES, enter delivery address below :

0

No

Ice Type

Mod Mail D Express Mall

Registered

D

Return Receipt for Merchandise

D Insured Mail

D C.O.D .

4

. Restricted Delivery? (Extra Fee)

D Yes

102595.024-1540

I

RECK,EI VIED

MAY 2 2 2007

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