CLERK’S OFFICEJUL 292005STATE OF ILLINOiSPolfunon Controj BoardSENDER: COMPLETE THIS SECTION COMPLETE THIS SECTION ON DELIVERYU Complete items 1,2, and 3.
Also complete
item 4 if Restricted Delivejy is desire~i • Print your name and address orfthe reverseso that we canreturn the card to you.
U Attach this card to the back of the mailpiece,
or on the front if space permits.
ORIGINAL
A.
S~natur~
X DAgent .2 0 Addressee1.
MicleAddressedto: 7/21/05 B.M.
PCB 2005—013Katina Maglaya617 Devon AvenuePark Ridge, IL 60068 B. Received by (f~n7edName) C. Date of...
Allowed
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