i~A~
RECEIVED
CLER~cs
OFFICE
FEB
2
2005
STATE OF ILLINOiS
POIjUtjOfl Control Board
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.
U
Attach this card to the back of the mailpiece,
or on the front
if space permits.
1.
ArticleAddressed to:
2/3/05
j
.T.
PCB 2005—129,131,132,136&137
Ken Maschhoff
7475 State Route 127
Carlyle,
IL
62231
2.
Article Number
(Transfer from
service label)
7004
PS Form
3811,
February 2O04
/
C.
Date of Delivery
Is delivery address different fmm item 1?
~
Yes
If YES, enter delivery address below:
0
t’lo
3.
ServIce Type
o
Certified Mail
0
Express Mail
o
Registered
0
Return Receipt for Merchandise
o
Insured Mail~
0
C.O.D.
4.
Restricted
Delivery?
(E~ctraFee)
0
Yes
2890
0004
2296
0740
Domestic Return Receipt
102595-02-M-1540
A.
Si~ature
X~~/)1f~i
B.
Re~éived
by~P~nteq
Name)
I
~i(i~S~
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