1. Page 1

 
RECEIVED
CLERKS OFFICE
MAR 3 1 2006
OF ILLINOIS
Dot, t
.
OT
,
Control Board
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 lf space permits.
I. Article Addressed to:
3/20/08 B.M.
PCB 2004-065
Katherine D. Hodge
Hodge Dwyer Zeman
3150 Roland Avenue
Post Office Box 5776
Springfield, IL 62705-5776
COMPLETE
THIS
SECTION
ON DELIVERY
A.
Sign
X
0 Agent
0 Addressee
B.D.
Is
Asalved
Pr,
delivery
4
by
address
.1
(Printed
L
e
different
i
Name)
from
?
item
C.
1?
Datatrivery0
Yes
If YES, enter delivery address below:?
0 No
3.?
Ice Type
Med Mall 0 Express Mall
Registered?
0 Return Receipt for Merchandise
0 Insured Mail?
0 C.O.D.
4. Restricted Delivery?
(Extra Fee)?
0 Yes
2. Article Number
(Transfer from service lab.°
7007 3020 0000 4630 5388
PS Form
3811,
February 2004
?Domestic Return Receipt
102595-02-M-1540

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