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-~

    Back to top