REC~V~D
    CLERK’S OFFICE
    DEC 20
    2004
    STATE OFJLL~NQI~
    POIIUtjO~Control
    Board
    SENDER
    COMPLETE THIS SECTION
    •
    Complete items
    1, 2,
    and 3. Also
    complete
    A.
    Signature
    ~
    item
    4 if Restricted Delivery is
    desired.
    x
    ‘TL
    A
    —.
    U
    0 Agent
    •
    Print
    your name and address on
    the reverse
    ‘I ~&t/
    ~-&_
    LLit
    /LL-
    ~
    D Addresse~
    so that we can return the
    card to you.
    s
    F~eceivedby
    (Printed Name)
    1
    C.
    Date of Delivi~y
    •
    Attach
    this card to the back of the mailpiece,
    -
    (‘
    I
    t~c~—t~i
    or on
    the front if space permits.
    V
    ~
    :~
    i7~1~i’~
    I”
    /
    ,-
    D.
    Is delivery address
    tifferefrt~f~&1i
    ite~1?0
    Yes
    1.
    Article Addressed
    to:
    12
    /
    2
    /
    04
    B
    M.
    ,~‘
    If
    YES, enter delivery address bek~~ 0
    No
    AC
    2004—13
    Eddie Greer
    9923
    S. Peoria
    Chicago,
    IL 60643
    3.
    S2rvice Type
    ~..Certif
    led Mail
    D~Ei~pr~s
    Mail
    t:i
    Registered
    0
    Return
    Receipt for Merchandise
    o
    Insured Mail
    0
    0.0.0.
    4.
    Restricted
    Delivery?
    (Extra Fee)
    0
    Yes
    2.
    Article Number
    (rransfer from sen,icelabel)
    7004
    0750
    0004
    3960
    1871
    PS Form
    3811,
    February 2004
    Domestic Return
    Receipt
    102595-02-M-154o
    /

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