D. Is delivery address different from item 1? 0 Y~s

If YES, enter delivery address beIôw~

0 No

3. Syvice

Type

~-bertifIed Mail

‘0. RegEstered

Cl Express Mal

0

Return Receipt fo’r Merchandise:

iJinsured M~1I. 0 C.0D.

4. Restricted Delivery?

(Extra Fee)!

0 Yes

2 ArtIcle Number

an~ferfromsenfice~e.be~

7002 0860 0004 9618 4988

P~Form 3811 Feb~ary2004

Domestic~ReturnReceipt

iozsas.o~

M1540

REC~JVED

CLERK’S OFFICE

AUG 162004

STATE OF ILLINOIS

P~II~tj~~Control Board

M~:Complete items 1, 2, and 3. Also complete

ifem 4 if Restricted Delivery is desired.

• Print your name and address on the rever~e

so that we can return the card to you.

• Attach this card to the back of the mailpiece,

or on the front if space permits.

1. Article Addressed to:

8/5

/ 04 B. M.

PCB 2004—188

Paul Phelan

406 West Carpenter Street

Jerseyville,

IL 62052

I

0 Agent

Addressee

~4~ad.~y

(PñnfedName)

C.

Dat of Deity