SENDER
    COMPLETE
    THIS SECTION
    a
    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.
    a
    Attach this card to the back of the
    mailpiece,
    or on
    the front if space permits.
    1.
    Article Addressed to:
    1
    /
    20
    /
    05
    B
    .
    M.
    /
    AC
    2005—034
    Earl Cazel
    407
    E.
    South Street
    Dwight,
    IL 60420
    C~1V~
    CLEF~’8
    OFFICE
    FEB
    142005
    STATE OF
    ILLINOIS
    PoIlu~0~
    Controi
    8oard
    A.Si
    ure
    -
    ~~ssee
    ,~..Received
    by
    (Prints.
    Name)
    C.
    D.
    Is delivery address different from item 1?
    0
    Yes
    If YES, enter delivery address below:
    0
    No
    3.
    ServIce Type
    o
    Certified
    Mail
    o
    Registered
    O
    Insured Mail
    o
    Express Mail
    o
    Return
    Receipt for Merchandise
    o
    COD.
    4.
    Restricted
    Delivery? (Extra
    Fee)
    7004 0750
    o~oO4;-~6o
    2489
    0
    Yes
    PS
    Form
    381
    1,
    February 2004
    DomesticReturn Receipt
    102595-02-M-1540

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