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