SENDER :

COMPLETE THIS SECTION

•

Complete items 1, 2, and 3

. Also complete

its , 4.if.

.Restricted Delivery 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 .

.

Article Addressed to: 5/17/07 B .M .

PCB 2007-107

Tracy Kitley

13890 Old Highway 50

Clay City, IL 62824

I

12 . Article Number

(rrsnsferfmmservicelaben ' 7006 2760 0003 5423 6775

Ps Form

3811, February 2004

Domestic Return Receipt

COMPLETE THIS SECTION ON DELIVERY

0 Agent

0 Addressee

B. Received by (Printed Name)

C . Datecry

D

. Is delivery address different from ftem 17 Dyes

If YES, enter delivery address below

:

0 No

Ice Type

ad Mall

0 Express Mall

Registered

0 Return Receipt for Merchandise

0 Insured Mall

0 c.O.D .

4 . Rest cted Delivery?

(Extra Fee)

0 Yes

102595-02-M-1540

RECEIVED

CLERK'S OFFICE

MAY 2 9 2007

Pollution Control Board

IL