RECEIVED

~

CLERK’S OFFICE

~I

~1

~

FEB 282005

~0nCofl~d

SENDER

COMPLETE THIS SECTION

COMPLETE THIS SECTION ON DELIVERY

•

Complete items 1, 2, and 3. Also

complete

A.

Sigpat,re

item 4

if

Restricted

Delivery is desired.

x

~

0

Agent

0

Addressee

U

Print your name and address on the reverse

_____________________________________________

so that we can

return the card to you.

~R~ceived by

(PrintedName)

I

C.

Date of Delivery

U Attach this

card to the back ofthe

mailpiece,:

/

J~.

~

I ~

or on the front if space permits.

D.

Is delivery address different from item 1?

t

Yes

If YES, enter delivery address below:

0

No

1.

Article Addressed to:

2

/

17

/

05

B

M.

AC 2005—045

Ronald

C.

Seei

26377

E.

1200 Street

Geneseo,

IL 61254

3.

Service Type

~.Certjfied

Mail

0

Express Mail

dtJ

Registered

0

Return

Receipt for Merchandise

o

Insured Mail

0

C.O.D.

4.

Restricted

Delivery?

(E~tm

Fee)

0 ~.Yes

2.

Article Number

(Thansfer

from

service label)

7004 2890 0004 2296 0795

PS

Form

3811,

February 2004

Domestic Return

Receipt

102595-02-M-1

540