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SENDER: COMPLETE

THIS SECTION

?

COMPLETE THIS

SEC

TION ON DELIVERY

q

Agent

q

Addressee

Printed Name)

?

I

C. Date of Delivery

1.Article

Addressed to:

?

1/24/08B.M.

a

AC 2005-072

Gary Clover

Clover Concrete

11704 North Route 37

Marion, IL 62959

4. Restricted Delivery?

(Extra Fee)

?

q

Yes

2.

Article Number

(Transfer from service label)

7006 0810 0004 2225 2270

PS Form

3811,

February 2004

?

Domestic Return Receipt

102595-02-M-1540

■

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 mailplece,

?

B. R Ned

or on the

front If space permits.

. Is del

If YES

A. Signature

X

3. Service''

q

Cart

?

Express Mall

q

Registered

?

q

Return

Receipt

for Merchandise

q

Insured Mall

?

CI

C.O.D.