COMPLETE THIS SECTION ON DELIVERYComplete items 1, 2, and 3.
Also complete
Item 4 if Restricted Delivery is desired.
Attach this card to the back of the mailpiece,
or on the front if space permits.
726 S.
Second Street
Springfield, IL 62704 D AgentD AddresseeB.
Re jy (Printed Name) C. Date of Delivery
D. Is delivery address different from Hem 1 ? D YesIf YES, enter delivery address below: O No3. Service Type^Certified Mall □ RegisteredD Insured Mall □ Express MallD Return Receipt for Merchandisea c.O;D.4. Restricted Delivery?
Allowed
Adobe Portable Document Format (.pdf) - application/pdf
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