ORIGINAL
RECEIVED
CLERKS OFFICE
OCT 192005
STATE OF ILLINOIS
PoHuflon Control Board
SENDER:
COMPLETE THIS SECTION
COMPLETE THIS SECTION ON DELIVERY
A. Sign
ure
• Complete items 1,2, and 3. Also complete
x!V~
item 4 it Restricted Delivery is desired.
• 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 or~ front if space permits.
1. AstlcieAdclressedto;
10/6/05 B.M.
AC 2005—029
7
Charles Riggins
10364 N.
CR 2800 E
Easton,
IL 62633
I 3.
rvice Type
rtffled Mall
D Registered
El Insured Mail
4.
Restiloted
Delivery?
(Extm
Fee)
0 Yes
2. ArtIcle Number
(r,ansforfromservlcelahep
7005 1160 0002 2069 3701
O
Agent
0 Addressee
.~. RepelvpçJby(Pfinted)~
C. Date of Delivery
Ct Kc2~ws
D.
is
deftvery address
different
horn lten~
1?
0 Yes
If YES, enter delivery address below:
0 No
El Express Mall
o
Retum ReceIpt for Merchandise
o C.O.D.
PS Form
3811, February
2004
Domestic
Return Receipt
102595.02-M-1
540
