SENDER:

COMPLETE

THIS

SECTION

•

Complete

Items

1,

2,

and

3.

Alo

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:

10/16/08

B.M.

AC

2009—011

Joseph

Flick

315

Vine

Street

Cobden,

IL

62920

ECEVD

CLERK’S

OFFICE

OCI

302008

STATE

OF

ILLINOIS

PUtjo

Control

Board

2

Article

Number

(rransfer

from

sefvice

label)

7008

0500

0000

4545

6295

PS

Form

3811,

February

2004

Agent

Addressee

B.

eceived

by

(Printed

Name)

C.

Date

of

Delive

P)

cfC

iok-j

6.

Is

delivery

address

different

from

item

1?

Yes

If

YES,

enter

delivery

address

below:

D

No

3.

Srvice

Type

rtified

Mall

Registered

D

Insured

Mall

I]

Express

Mail

D

Return

Receipt

for

Merchandise

D

C.O:D.

4.

Restricted

Delivery?

(Extra

Fee)

0

y

Domestic

Return

Receipt

1

02595-02-M-1

540