•
Complete items
1,
2, and 3.
Also complete
item
4
if Restricted Delivery is desired.
•
Print your name and addres&on the reverse
so that we can
return the card to you.
•
Attach this card to the back of the
m.ailpiece,
or on the front if space permits.
C
1.ArticleAddr~ssedto:
4/21/05
B .M.
PCB
2005—096
STATht~~Lawrence
A.
Lipe
poUutiOfl°°~
Lawrence A.
Lipe & Associates
901
North DuQuion Street
P.O. Drawer 130
Benton,
IL 62812
2.
Article
Number
(Transfer from service Iabe()
PS Form
3811,
February 2004
rti
o
Agent
O
Addressee
I
B~/Received
by
(~Printed
Name)
C.
a
~Delivery
~
D.
Is
delivery address different from item
1
?/
iJ
‘s
If YES,
enter delivery address below~
0
No
0
Insured
Mail
0
C.
4.
Restricted
Delivery? (Ext/a Fee)
0
Yes
7004 2890 0004 2296 5004
Domestic Return Receipt
102595-02-M-154o
SENDER:
COMPLETE THIS SECTION
COMPLETE THIS SECTION ON DELIVERY
•
Completo.items 1, 2,
and 3. Also complete
item
4
if Restricted
Delivery is. desired.
•
Print your name and
address on the reverse
so that We
can return the card to you.
•
Attach this~card~tb.the
back of the mailpiece,
or on the fi~nt
If space permits.
1
MlcleAddrei~Wto
4/21/05 B
N
PCB 2005—~6
Village of North City Clerk
Village of North City
P.O.
Drawer E
Coello, IL 62825
A.
Signature
xG?4,~
~
X.~tgent
Addressee
B.
Received by
(Printed
Name)
fJ~
)1~
)~rjv’~d
C.
Date of Delivery
05
~b.
Is
delivery address differentfrom item
1?
0
Yes
If YES, enter delivery address.below:
~No
~Rô.
8Q)(
~
3.
S,r~vlceType
~ertified
Mall
IJ
Registered
0
Express Mail
0
Return Receipt for Merchandise
0
Insured Mail
0
C.O.D.
•
4~
Restricted Delivery?
(Extra
Fee)
.0
Yes
2.
ArtIcle Number
(rransferfromsen’/celab&)
7,004 2890 0004 2296:;5011
9flfl4
Domestic Return
Receipt
102595-02-M.1
540
N Comp~~
items
1, 2,
and 3. Also complete
j~atu~iIl
item
4 if Restricted Delivery is
desired
~
Agent
•
Print your name
and
addres~
on the reverse
C
Addressee
so that we can
return the card to you.
‘
eivejj b
Pr!
ted Name)
C.
Date ofDeliv~,~
/
I
Affachthisc~d~thb
mailpiece
/
5/
~
7
D.
Is delivery address d~erent
~m
item
1?
0
Yes
I.
Article Addressed to
4/21/Q5
B.
M.
,.
If YES,
enter delivery address below:
0
No
Mark
C.
Coldenberg
Altman_Charter ‘Company
2227
S.
State Route 127
-
Edwardsvjlle,
IL 62025
‘
~I~.~~0iYP0
QEXPresSMalp
C
Registe~~
0
Return
Recelpt for Merchandise
C
Insured
Mail
~
c.O.D~
4.
Restricted Delive~~/a
Fee)
C
Yes
~
0851
I
PS
Form
3811,
February 2004
.
Domestic
R~
~
APR
292005