tYRI G’1~
    ~JL
    F’;
    JAN
    1 ~i2O~
    STATE OF ~LLU\~O~S
    E~o~ut~0fl
    Contr0~
    Board
    SENDER
    COMPLETE THIS SECTION
    COMPLETE THIS SECTION ON
    DELIVERY
    Complete items 1, 2, and
    3. Also
    complete
    A. Signatury
    /
    )
    item 4 if Restricted Delivery is desired.
    ~
    •
    Print your name and address on the reverse
    -L4.~’-(/L/~,!
    ~
    so that we can return the card to you.
    3’~Received by
    (Printed N~me)
    C.
    Date of Delivery
    •
    Attac~t.thiscard to the back of the mailpiece,
    /~..
    ,~
    ‘(~-j,,~-~//
    ‘—/~P’--L9.S
    oro~ihefrontifspacepermits.
    j
    ‘~~/~~‘i
    iW
    1w.
    /
    I
    D.
    Is delivecy address different from item 1?
    0
    Yes
    1.
    Article ‘Addressed to:
    1
    / 6/05
    B
    .
    H.
    /
    IfYES,
    enter delivery address below:
    0
    No
    PCB
    2005—112
    VI
    Jack Hart
    Adair Ag.,
    LLC
    9960 E.
    2lOOth Street
    3.
    Service Type
    Adair,
    IL
    61411
    ‘$..~ertified
    Mail
    0
    Express Mail
    (0
    Registered
    0
    Return
    Receipt for Merchandise
    0
    Insured
    Mail
    0
    C.O.D.
    4.
    Restricted
    Delivery?
    (Extra Fee)
    0
    Yes
    2.
    Article Number
    (Transfer from service label)
    7004
    0750
    0004
    3960
    2373
    PS Form
    3811,
    February 2004
    Domestic Return
    Receipt
    102595-02-M-1540

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