CLERKS OFFICEOCT 192005STATE OF ILLINOISPoHuflon Control BoardSENDER: COMPLETE THIS SECTION COMPLETE THIS SECTION ON DELIVERYA.
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x!V~ • Complete items 1,2, and 3.
Also complete
item 4 it Restricted Delivery is desired.
• Attach this card to the back of the mailpiece,
or or~ front if space permits.
(Extm Fee) 0 Yes
2.
ArtIcle Number
(r,ansforfromservlcelahep 7005 1160 0002 2069 3701 O Agent0 AddresseeC. Date of Delivery .~. RepelvpçJby(Pfinted)~Ct Kc2~wsD. is deftvery address different horn lten~1? 0 YesIf YES, enter delivery address below: ...
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