Complete items 1,
    2, and 3. ~iso complete
    item
    4 if Restricted
    Delivery is desifed.
    •
    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 mailpiece,
    or on
    the front if~space
    permits.
    1.
    ArtlcleAddressedto:
    9/16/04
    B.m.
    AC 2005—013
    Roy Bruce
    REC~JVED
    CLERK’S OFFICE
    SEP
    22
    2064
    STATE OF ILLINOIS
    POH~tj~~
    Control Board
    18456 E. Hawk Road
    3.
    S~rvice
    Type
    )SPertified Mail
    El,
    Registered
    0
    ~nsured
    Mali
    4.
    Restlicted
    Delive,y?
    (Ext,~
    Fee)
    2.
    Article
    Number
    I
    (rransfe~fromser,IceIabe!)
    7004 1160 0005 4123 1614
    SENDER:
    COMPLETE THIS SECTION
    J
    COMPLETE THIS SECTION ON
    DELIVERY
    A.
    Signatu
    ,
    U
    Agent
    4’1~i._
    JJ
    Addressee
    edby
    (Printed
    Name)
    Mt.
    Vernon,
    IL 62864
    D.
    Isdehvery
    address diffetentftom fterri~1?
    0
    Yes
    if
    YES, enter delivery address beIow~
    0
    No
    q
    Express Mail
    O
    Return
    Receipt for Merchandise
    o
    C.O.D.
    0
    Yes
    PS Form
    3811,
    February 2004
    Doméstlo Return
    Receipt
    102595-02-M.1 540

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