ENDER :

COMPLETE THIS SECTION

COMPLETE THIS SECTION ON DELIVERY

I , /I A //

C Date ofDelive

WIPF

∎ Complete items 1, 2, and 3

. Also complete

item 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

.

1 . Article Addressed to

: 4/19/07 B .M

AC 2005-040

Peter DeBruyne

Peter DeBruyne, P

.C .

838 North Main Street

Rockford, IL 61103

2

. Article Number

(Transfer from ser4celabel) 7001

1140 0002 7469 0411

PS Form 3811, February 2004

Domestic Return Receipt

ENDER : COMPLETE THIS SECTION

I Complete Items 1, 2, and 3 . Also complete

item 4 if Restricted Delivery is desired .

I

Print your name and address on the reverse

so that we can return the card to you.

D Attach this card to the back of the mailpiece,

or on the front if space permits .

. Article Addressed to

:

4/19/07 B .M .

.C 2005-040

,ewis B . Kaplan

38 North Main Street

.0 . Box 1254

.ockford, IL 61105-1254

X

4 Restricted Delivery? (Extra Fee)

Article Number

(Transfer from servIcelabel)

7001

1140 0002 7469 0428

S Form 3811,

February 2004

Domestic Return Receipt

ENDER : COMPLETE THIS SECTION

I

Complete items 1, 2, and 3 . Also complete

Item 4 if Restricted Delivery is desired .

I

Print your name and address on the reverse

so that we can return the card to you .

I

Attach this card to the back of the mailpiece,

or on the front if space permits

.

Article Addressed to:

4/19/07 B .M.

C 2005-040

Dyne Klinger

orthern Illinois Service Co .

781 Sandy Hollow Road

ickford, IL 61109

deli e ry address different from item

?

0 Yes

enter delivery address below

:

0 No

e Type

ad Mall 0

Express Mall

Registered

0 Return Receipt for Merchandise

0 Insured

Mall

0 C.O.D .

4

. Restricted Delivery? (Extra Fee)

0 Yes

B . Received by (

t9

d Name)

SNjer-0

.

F

ts

FtZtf'rlsn

D

. Is delivery address different from its

If YES, enter delivery address belo

No

4 Restricted Delivery? (Extra Fee)

Article Number

(Transferfmmservicelabel)

7001 1140

0002 7469 0404

Form

3811, February 2004

Domestic Return Receipt

0 Agent

0 Addressee

102595-02-M-1540

COMPLETE THIS SECTION ON DELIVERY

A. Signatu

0 Agent

/yJ 0Addressee

B .

eived

by (Pr/nted Name)

C

. Date'of Dell

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4-2

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D. Is delivery address different from item 1?

0 Yes

If YES, enter delivery address below:

0 No

3 . Service Type

(fled Mall 0 Express Mail

10 Registered

0 Insured Mall

0 Return Receipt for Merchandise

0 C.O .D.

0 Yes

102595-02-M-1540

COMPLETE THIS SECTION ON DELIVERY

A Sign re

X

of

ery

13

6

see

3e Type

i

rtlfled Mall 0 Express Mail

Registered

0 Return Receipt for Merchandise

0 Insured Mail

0 CO D

.

0 Yes

102595-02-M-1540

OR 'GNNAL

RECEIVED

CLERK'S

OFFICE

MAY 0

1 2007

Pollution

STATE OF

Control

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