SENDER
    COMPLETE
    THIS
    SECTION
    LERK
    S
    OFFICE
    5
    I2
    STATE
    OF
    ILLiNOiS
    PIItt
    Control
    Board
    A.
    Signature
    B.
    Received
    by
    (Pri
    dNa,fle)
    41ö.
    Date
    of
    Delivers’
    ‘
    %Wk’
    D.
    Is
    delivery
    address
    different
    frem
    item
    1
    ?
    El
    Yes
    /
    If
    YES
    enter
    delivery
    address
    below
    El
    No
    3.
    Sprvice
    Type
    ‘.Certified
    Mall
    El
    Express
    Mall
    II]
    Registered
    El
    Return
    Receipt
    for
    Merchandise
    El
    Insured
    Mail
    El
    C.0.D.
    4.
    Restricted
    Delivery?
    (Ext,a
    Fee)
    El
    Yes
    •
    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.
    •
    Attachthis
    card
    to
    the
    back
    of
    the
    mailpiece,
    or
    on
    the
    front
    if
    space
    permits.
    1.
    ArticleAddressedto:
    9/30/08
    B.M.
    AC
    2009—005
    Donald
    I.
    and
    Mary
    A.
    Jenning/
    R.R.4,
    P.O.
    Box
    31
    Mt.
    Sterling,
    IL
    62353
    2.
    Article
    Number
    rransferfromseiviceIabeI)
    7007
    3020
    OQOO
    46307474
    PS
    Form
    3811,
    February
    2004
    Domestic
    Return
    Receipt
    102595-02-M-1540

    Back to top