•

Complete items

1, 2, and 3. Also complete

•

item

4 if Restricted Delivery is de~ired~

•

Print your name and address on

the reverse

so that weca~u~fhecard to you.

•

Attach this cai~T&fhe

back of the mailpiece,

or on the front if space permits.

1.

ArticleAddressedto:

8/5/04

B.M.

PCB 2004—189

Kent Ochs

Wabash Valley Service,

Inc.

P.O.

Box 333

Fairfield,

IL 62873

A.

Signature

x (~JJ~4

~7~!;IiL~-

~SS~e

$

~eceived

by

(Printed Name)

C.

Date of

Delivery

~

(q

~

~~ock~D~

g-13_O1/

D.

Isdelivery address different from item 1?

0

Yes

LL~

If YES, enter delivery address below;

0

No

3.

Sejvice Type

ertified

Mail

0

Express Mail

Registered

0

Return

Receipt for Merchandise

0

Insured

Mail

0

C.O.D.

4.

Restricted

Delivery?

(Extra Fee)

-

0

Yes

2

Article

Number

—

psferf?om~jvIce/ab~I)

7004

1160 0005 4126 2991

PS Form

3811

Feb~uar~’

2OO~4

Domestic Return

Receipt

10259502 M 1540

IE

~

16

2004

po8,~ti~n

~