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 thatwe can return the card to you.
•
Attach this card to the back of the mailpiece,
or on the front if space permits.
1.
ArticleAddressedto:
2/17/05
AC
2005—045
Curtis R.
Seei,
Registered Ager
Double
S.
Masonry,
Inc.
2.
Artiôle
Number
(rransferfromseMceIab~!)
7004
2890
e0004
2296
0801
19 Edgewood Drive
Geneseo,
IL 61254
RECEIVED
CLE~ç’8
OFFICE
MAR
1
02005
STATE OF ILLINOIS
POII~tj~~
Control Board
p6..
Is delivery address
different
from
item
1?
If YES, enter
delivery address below:
0
Yes
0
No
~3.
~SeMce
Type
Ø.Certified
Mail
0
Express Mail
‘tJ
Registered
0
Return
Receipt forMerchandise
0
Insured Mail
0
C.O.D.
4.
Restricted Delivery?
(Ext,s
Fee)
0
Yes
B.
Received
by
(Printed Name)
C~~’o9Ø~~ry
PS. Form
3811,
February 2004
Domestic.Returri Receipt
lO2595-O2-M-~