A.S areX ~J~JL’U 0 AgentAddresseeB. Re~Je~4d (~iq~pç1N me) 4 fl C.ate of DeliveryUL~YD. l~deliveryaddress different fràm item 1? 0 YesIf YES, enter delivery address below: 0 NoNorth Rockwell222 N. LaSalle Street, #1910Chicago, IL 60601 3. ServIce Type~~rtlfied Mallgj Registered 0 Express Mail0 Return Receipt for Merchandise0 Insured Mail 0 0.0.0.4. RestrIcted Delivery? B. Received by (P d e) C. Date of Delivery ...
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