ORIGINAL

SENDER : COMPLETE THIS SECTION

1 ∎ Complete items 1, 2, and 3. Also complete

1 ∎

item

Print

4

your

if Restricted

name and

Delivery

address

Is

on

desiredthe

reverse

.

I

so that we can return the card to you .

I ∎ Attach this card to the back of the Tailpiece,

or on the front if space permits .

1

AC1

. Article

;°1007-026q1007-026

;

Addressed to: 1/26/07 B .M .

Leonard Hostetler

1335 State Highway 121 South

I Mt . Zion, IL 62549

I

I

II

2 . Article Number

(Tiansferfrom

Service label)

7000 1140 0002 7469 0640

PS Form 3811, February 2004

Domestic Return Receipt

0

Agent

0 Addressee

C . Date o Delivery

RECEIVEDCLERK'S

OFFICE

F

-E B ~

3 2007

Pollution

STATE OF

Control

ILLINOIS

Board

COMPLETE THIS SECTION ON DELIVERY

D. Is delivery address different from item 17 0 Yes

If YES, enter delivery address below:

0 No

4

Nice Type

riffled Mall O Express Mail

Registered

0 Insured Mail

0 Return Receipt for Merchandise

0 C.O

.D

.

Restricted Delivery? (Extra Fee)

0 Yes

102595-02-M-1540