ORIGINAL

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:

1/20/05

B

AC 2005—005

V

Robert A. IJirich

Bob lunch Pallet, Inc.

1913 S. 59th Street

Quincy, IL 62301

CCEF~’S OFFICE

FE~1172005

STA1~O~ILLINOIS

PQlIUUor~Control 8oard

0 Agent

0 Addressee

B. Received by

(Printed Name)

C. Date of peIiver~

$‘o~,rt2/zjerc/?

-zf3/15~

3. Service Type

o Certified Mai’

0 Express Mail

o Registered

0 Return ReCeipt for Merchandise

o Insured Mail

0 0.0.0.

0. Is delivery address different from item 1? )t ‘~s

If YES, enter delivery address below:

0 No

4. Restricted Delivery?

(Extra Fee)

0 Yes

2. Article Number

i

(Transfer from ser.4ce IabeO

7004 0750 0004 3960 2441

PS Form 3811, February 2004

Domestic Return Receipt