RECE
    WED
    CLERK’S OFFICE
    MAR
    2 ~2005
    STATE OF ILLINOIS
    PoUutiOfl Control Board
    SENDER:
    COMPLETE THIS SECTION
    COMPLETE THIS SECTION ON
    DELIVERY
    •
    Complete items 1,
    2, and 3. Also complete
    item
    4 if Restricted Delivery is desired.
    I
    •
    Print your name and address on
    the reverse
    so that we can
    return the card to you.
    •
    Attach this card to the back of the mailpiece,
    or on the front if space
    permits.
    ,
    1.
    Article Addressed to:
    3/17/05
    B .M.
    PCB ‘2005.-i 60
    Dr.
    Steve Feurbach
    2435 Bethany Rd.
    Sycamore,
    IL 60173
    r’Receive~Y
    (Printed Name)
    C.
    Date of Delivery
    S
    ice Type
    ertif
    led
    Mall
    0
    Express
    Mail
    Registered
    0
    Return
    Receipt for
    Merehandise
    0
    Insured
    Mail
    0
    C.O.D.
    4.
    Restricted Delive ry7
    ~E’ct,a
    Fee)
    0
    Yes
    A.
    Signature
    0
    Agent
    X
    ~No
    A-~~
    0
    ,-
    0
    Addressee
    D.
    Is delivery address different from item 1?
    0
    Yes
    If YES, enter delivery address below:
    0
    No
    2.
    Article Number
    -
    (rransfer from
    service
    label)
    7004
    2890
    0004
    2296
    ~564
    PS Form
    3811,
    February 2004
    Domestic Return
    Receipt
    102595-02-M-1540

    Back to top