SENDER: COMPLETE THIS SECTION COMPLETE THIS SECTION ON OEJVFRY
Complete items 1, 2, and 3.
Also 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: 1/7/10 B.M.
PCB 2010-047Mark Van Holton19170 Rush RoadLyndon, IL 61261 G AgentC-AddresseeD. Is delivery address different from Item 1 ?" □ YeIf YES, enter delivery address below: D No3. Sen/Ice Type
fi^Q-riifiod Mall
CD RegisteredD Insured Mall D Expres...
Allowed
Adobe Portable Document Format (.pdf) - application/pdf