RECEIVED

CLEPK’S OFEtCE

•

Complete

items.1, 2, and

3. Also complete

item

4

if

Restricted Delivery

is desired.

U

Print your name 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.

ArticleAddressedto:

4/7/05

-

B.N.

PCB 2002—207

N.

LaDonna Driver

Hodge Hwyer Zeinan

3150 Roland Avenue

P.O.

Box

5776

-

Springfield,

IL 62705—5776

~c~J

~

II

~1-

Y

A. S~~Ur~

~—

‘~_I—

~1-

~0 Agent

0

Addressee

B.

elved

by

(Printed

Name)

~ee_

C.~

0

te

f

Delivery

4~1-6~1~

D~

Is

delivery

address

different from

item 1?

0

Yes

If YES, enter

delivery address below:

0

No

SENDER:

COMPLETE-THIS SECTION

/

3~S~rvice

Type

ertifled

Mail

Registered

0

Insured Mail

0

Express

Mail

o

RetUrn Receipt for Meroharidise

o

C.O.D.

4.

Restrictud

Delivery?

(Extra Fee)

2.

Article Number

(Transferfrom sen’ice label)

7004

2890

0004

2296

4601

DomestIc. Return

Receipt

1 O2595-O2-M~t54b

0

Yes

PS

Form

3811,-

February 2004