A. SignatureX Received by (PrintedName) Ag0 AddIs delivery address different from Item 17 0 YIf YES, enter delivery address below : 0 No1 . Article Addressed to : 5/1ACC2007-036, AC 200AC 2007-038Lawrence A. Bartolom ` P.O. Box 2325Mt. Vernon, IL 62864I 2. Article Number(Transfer froms...
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