S
Complete items
1,
2,
and 3.
Also
complete
item
4 if
Restricted
DeTivery
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:
10/16/08
B.M.
PCB
2007—046
Brian
Konzen
Lueders,
Robertson
&
Konzen
1939
Delmar-Avenue
P.O.
Box
735
Granite
City,
IL
62040
CLERK’S
OFFICE
OCT
2’7
2008
STATE
OF
IWNOj
2oIlut
ion
Control
Board
B.
Received
by (Printed
Name)
C. Date
of
Delivery
D.
Is delivery
address
different
from
fter*1?
[]Yes
If YES,
enter
delivery
address
below:
ci
No
SENDER
COMPLETE THIS
SECTION
A.
COMPLETE
Signature
THIS
SECTION ON
DELIVERY
1
ent
ci
Addressee
3.
Service
Type
ertified
Mail
Registered
ci Insured
Mail
O
Express
Mail
ci Return
Receipt
for
Merchandise
ci
C.O.D.
4.
Restricted
Delivery?
(Extra
Fee)
ci
Yes
2 Article
Number
(T,ansferfmmse,vicelabes9
7008
0500
0000
4545
5137
PS
Form
3811,
February
2004
Domestic
Return
Receipt
102595-02-M--1540