RECEIVED
CLEPK’S OFEtCE
•
Complete
items.1, 2, and
3. Also complete
item
4
if
Restricted Delivery
is desired.
U
Print your name and-address
on the reverse
so that we can return
the card to you.
U
Attach this card to the back of the mailpiece,
or on
the front if space permits.
1.
ArticleAddressedto:
4/7/05
-
B.N.
PCB 2002—207
N.
LaDonna Driver
Hodge Hwyer Zeinan
3150 Roland Avenue
P.O.
Box
5776
-
Springfield,
IL 62705—5776
~c~J
~
II
~1-
Y
A. S~~Ur~
~—
‘~_I—
~1-
~0 Agent
0
Addressee
B.
elved
by
(Printed
Name)
~ee_
C.~
0
te
f
Delivery
4~1-6~1~
D~
Is
delivery
address
different from
item 1?
0
Yes
If YES, enter
delivery address below:
0
No
SENDER:
COMPLETE-THIS SECTION
/
3~S~rvice
Type
ertifled
Mail
Registered
0
Insured Mail
0
Express
Mail
o
RetUrn Receipt for Meroharidise
o
C.O.D.
4.
Restrictud
Delivery?
(Extra Fee)
2.
Article Number
(Transferfrom sen’ice label)
7004
2890
0004
2296
4601
DomestIc. Return
Receipt
1 O2595-O2-M~t54b
0
Yes
PS
Form
3811,-
February 2004