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COMPLETE THIS SECTION

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Complete items 1,

2, and 3. Also compLete

item 4

if Restricted Delivery is desired.

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Print.yourname 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.

1.

Article Addressed

tot,

2/17/05

B

.

M.

AC 2004—031

ThomasJ.

Immel

Feldman, Wasser, Draper &

Benson

1307 South Seventh STreet

P.O. Box 2418

Springfield, IL

62705

2.

ArtIcle Number

(Transfèrfromse,vicelabel)

7004 2890 0004 2296 0764

A.

Signa~ure

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B.

~ecelvedby

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ad

Name)

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~Agent

0

Addressee

C.

Date of

D,JiverY

~

1~O~

~D.

Is

dèliveiy add~s~

different

from item

1?

0

Yes

If

YES,’enterdelivery

address

below:

-

0

No

~S~ivice

Type

~.Certified Mail

0

Registered’

o

Insured Mail

o

Express-Mail

o

Return

Receipt for Merchandise

0.

C.O.D.

4~

Restricted

Delivery?

(Extra

Fee)

D~Yes-

PS

Form

3811,

February

2004

Domestic Return

Receipt

102595-02-M-1 540