DER

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.

ArticleAddressedto:

12/16/04

B.M.

~C 2005—032

ioseph

E.

Nack

~ack, Richardson

& Kurt

L06 North Main Street

.0. box 336

Galena,

IL 61036

E CE ~V ~!D

CLERK’S OFF~QE

DEC

2 72004

STATE

OF ~LUNO~S

Wi

Contro’

Board

o

Express Mail

o

Return

Receipt

for

Merchandise

o

C.O.D.

4.

Restricted

Delivery?

(Extm

Fee)

0

Yes

2.

Article Number

(rransferfromservice!abe!)

7004 0750 0004 3960

1956

PS

Form

3811,

February 2004

SENDER

COMPLETE THIS SECTION

•

Complete items

1, 2,

and 3. Also complete

item

4 if Restricted

Delivery is desired.

U

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.Article Addressed to:

12

/

16/04

B.

N.

‘~~-

2005—032

James Haas,

Jr.

12343 East Biackhawk Road

Stockton,

IL 60185

Domestic Return

Receipt

102595-02-M-1540

—

A

Sign

ure

~)j4l

DAgent

ddressee

Btkeceived

by

(Printed

Name)

~

I

C.

Datéof

Delivery

c.~

D.

Is

delivery address different from

item

1

0

s

If

YES,

enter delivery address below:

0

No

3.

Service Type

Certif

led Mail

0

Express Mail

o

Registered

0

Return Receipt

for

Merchandise

o

Insured Mail

0

C.O.D.

4.

Restricted Delivery

? (Extra

Fee)

0

Yes

2.

Article Number

(rransferfromservicelabe/)

7004

0750

0004

3960

1963

PS

Form

3811,

February 2004

ORIGINAL

3.

Service

Type

,~...CertifiedMail

o

Registered

o

Insured

Mail

Domestic Return Receipt

1 02595-02-M-1 540