OR~GANA.L
    SENDER
    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.
    •
    Attach this card to the back of the mailpiece,
    or, on the front
    if space permits.
    1.
    ArticleAddressedto:
    1/6/05
    B .M.
    PCB 2005—114
    Mike Mackie
    Spoon River FS,
    Inc. d/b/a
    C~V~!D
    CLERK’S OFF~CF
    r.i.
    A.
    i~i~i~i~i:i
    ~
    Si
    na ure
    iw~_
    ~
    X
    B
    1
    5
    /1
    ~
    C~-(-~..-~
    Received by
    (Printed Name)
    DAgent
    0
    Addressee
    C.
    D.
    Is delivery address different from
    item 11
    0 “t?s
    If YES, enter delivery address below:
    0
    No
    2.
    Article Number
    (rransferfrom service Iabes9
    3.
    Service
    Type
    ~bertified
    Mail
    ti
    Registered
    o
    Insured Mail
    o
    Express Mail
    o
    Return
    Receipt for Merchandise
    o
    C.O.D.
    STATE OF
    !LL~O~S
    Po~uti0fl
    Coritr0~So~ird
    /
    Riverland FS,
    Inc.
    1017 South
    IL Route
    180
    Williamsfield,
    IL 61489
    4.
    Restricted
    Delivery?
    (Extra
    Fee)
    7004 0750 0004 3960 2397
    0
    Yes
    PS Form
    3811,
    February 2004
    Domestic Return
    Receipt
    102595-02-M-1540

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