ORIGINAL
RECEIVED
CLERK’S OFF/CE
SEP
03
2~g~
STATE OF
ILLiNOIS
PoIJ~j~,
Control Board
SENDER:
COMPLETE THIS SECTION
• •
Complete items
1
2,
and 3. Also complete
Item
4
if Restricted Delivery
is desired.
S
Print
your
name and
address
on the reverse
so that
we can return the card to you.
•
Attach this card to the
back of the niailpiece,
or on the front if space
permits.
1. k~cIeAddressedto:
9/1/05
PCB 2001—115
Michael Lacy
BM/
Attorney at Law
2.
AilIcle
Number
oinnsmrn~rnservice7aQh~5
1160
0002
2069
3619
16650 South Canal
South Holland,
IL
60473
?tr~
IW~
Is
deffvety addSs different from
Item
~(10
tel
It YES, enter
delivenj
address below:
0
No
3.
&~vlce
Type
~Certffled
Mail
t
RegIstered
0
Express Mail
0
Return
Receipt
for
Me,thandlse
0
Insured
Mall
0
0.0.0.
4.
RestrIcted Deilvety? (Extre Fee)
3
& Sflu7~j~
3
Agent
o
Addressee
PS
Form
3811,
February 2004
Oomestlc’Return Receipt
102595-02-M-1540
