901 North DuQuion StreetP.O. Drawer 130Benton, IL 628122. Article Number(Transfer from service Iabe()PS Form 3811, February 2004 rti o AgentO AddresseeIB~/Receivedby (~PrintedName) C. a ~DeliveryD. Is delivery address different from item 1 ?/~iJ ‘sIf YES, enter delivery address below~ 0 No0 Insured Mail 0 C.4. Restricted Delivery? • Attachthis~card~tb.theback ofthe mailpiece,or on the fi~ntIf space permits. ‘ eivejj b Pr...
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