CLEF~K’S
    OFFICE
    JAN
    31
    2005
    STATE OF ILLINOIS
    PogIu~j0~
    Control Board
    A.
    X
    e
    ~
    ~
    ~
    Addressee
    B.
    ~
    Received by
    (Printed
    Name,)
    C.
    Date of
    Delivery
    ~
    ,~
    K
    D.
    Is delivery address different from item
    1?
    0
    Y,/
    If YES, enter
    delivery address below:
    0
    No
    3.
    Service Type
    o
    Certified 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
    ORIGINAL
    FENDER
    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.
    Article Addressed to:
    1/20/05
    B.M.
    AC
    2005—036
    Sheri L. Carey
    County of Sangamon
    2501 North Dirksen Parkway
    Springfield,
    IL 62702
    2.
    Article Number
    (Transfer
    from sen/ice label)
    7004 0750 0004 3960
    2557
    PS Form
    3811,
    February 2004
    Domestic Return
    Receipt
    102595-02-M-1540

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