SENDER: COMPLETE THIS SECTION COMPLETE THIS SECTION ON DELIVERY
Complete 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.
105 S.
Commercial
P.O.
Box 972
Harrisburg, IL 62946 BLfieceived by (Printed Name)D. Isdelivery address different from Hem 1? D YesIf YES, enter delivery address below: OH No3. Service Type^Certified Mall □ RegisteredD Insured Mail □ Express MailO Return Receipt for Merchandisen c.o.d.4. Restricted Delivery?
Allowed
Adobe Portable Document Format (.pdf) - application/pdf
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