OCT 312005
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 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:
10/20/05 B .M.
PCB 2005—49
Morton F. Dorothy
2413 E. Illinois
Urbana, IL 61801
STATE OF ILLINOIS
COMPLETE THIS SECTION ON tEL/VERY
~eived
b Please Print c any) B. Date of Deliv ery
C. Signature
0 Agent
_____________
________
~ddressee
Is delivery address different t~mitem 1? 0 Yes
It YES, enter delivery address below:
0 No
3. Service Type
~1
certified Mail
Registered
0 Express Mail
0
Return
Receipt
for
Merchandise
0 Insured Mail
0 coD.
4. Restricted Delivery?
(Extra
Fee)
0 Yes
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 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:
10/20105
B .M.
PCB 2005—049
• Thomas G. Safley
Hodge Dwyer Zeman
3150 Roland Avenue
Post Office Box 5776
Springfield, IL 62705—5776
C. Signature
—
0 Addressee
D. s delivery address different from item ~? 0 Yes
If YES, enter delivery address below:
0 No
3. Service Type
ertified Mail
0 Express Mail
Registered
0 Return Receipt for Merchandise
0 Insured Mail
0 coo.
flfl!.r’ip~1
RECEIVED
U N I
CLERK’S OFFICE
x
V
2. Article Number
(copy
from service
label)
7005 1160 0002 2069 4067
PS Form 3811, July 1&99
+
Domestic Return Receipt
102595-9gM-I789
COMPLETE THIS SECTION ON DELIVERY
A. Received by (Please Print Clearly)
Ur~~
Lee
B, Date of Delivery
.7
I
0 Agent
2. Article Number (Copy
from
serv/ce label)
7005 1160 0002 2069 4050
4. Restricted Delivery?
(Extra
Fee)
0 Yes
PS Form 3811, July 1999
Dom~sticReturn Receipt
102595-99’M’1789