CLERK’S OFFICE

NOV 30 2005

STATE OF ILLINOIS

PoHuuon Control Board

k Signature

~JiRece1ved

by

(PiinteqNar5s(

C. Date of

Delivery

.Jutit,

~aJi~ç’oc

p.

Is delivery

address

dlff~-it

from

Item 1? Cl Yes

If YES, enter delivery

address

below:

C

P4o

3. ServIce Type

CeTtIIIed Mall

C

Express Mall

‘Cl

Registered

Cl

Return Receipt

for

Meithandise

D

Insured Mall

Cl D.O.D.

4.

RestrIcted Delivery?

(Extra Foe)

C Yes

2. ArtIcle Number

(Tmnsferfrcmserviceiehel)

7005 1160 0002 2443 1217

ORIGINAL

SENDER:

COMPLETE THIS SECTION

COMPLETE THIS SECTION

ON

DELIVERY

• 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 mallpiece,

or on

the front if space permits.

~

a~a~M.

A’

0Cl

Agent

Addressee

PCB 2004—226

Julio Gallegos

I. NtlcleMdressedtc: 11/17/05 B.M.

4200 w.

Palner Stree~

Chicago, IL 60639

PS Form 3811, Februar,j Z0Q4.. — — - Dmestlc Return

Receipt

1259S02-M-1 540

ii III

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