OR~6RR~AAL
SENDER
COMPLETE THIS SECTION
S
Complete items 1, 2, and 3. Also complete
item 4 if Restricted Delivery iè desired.
• Print your name and addresson 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:
6
/2 /
05
B . M.
PCB 2005—089
Michael A. Toepfer
Vincent, Roth & Toepfer, P.C.
125 B. Main Street
P.O. Box
685
Warren, IL 61087
PIECEIVED
CLERK’S OFFICE
JUN 132005
STATE OF
ILLiNOIS
Pollution Control Board
3. ServIce Type
ertified Mail
0 Express Mail
Registered
0 Return Receipt for Meithandise
0 Insured Mail
0 C.O.D.
4. Restricted Delivety?
(Extra Fee)
0 Y~
2. Article Number
(Ttansferftumsefvlce.(at,ei)
7004 2890 0004 2307 1032
PS Form 3811, February 2004
Domestic Return Receipt
102595-02-M-1540
SENDER
COMPLETE THiS SECTiON
COMPLETE THIS SECTION ON DELIVERY
S
Complete items 1, 2, and 3. Also complete
item 4 if Restricted Delivery is. desired.
S Print your name and address on the reverse
so that we can return the card to you.
S Attach this card to the back of the mailpiece,
~
1. Article Addressed to:
PCB 2005—089
James William Vincent
1480 Rou~te 20 West
Elizabeth, IL 61028
6/2/05 B.M.~,,,/’
A. Signature
x2/i’~i
t~2a4d
~it
0 Addressee
jceiv~7Name)
~
D. Is delivery address different ftt~mitem1~i 0 ‘Yes
~
I.
3. S~rviceType
‘~-CertifledMall
0
Express Mail
D
Registered
D--~etumReceiptfo~Mershandise
4.
0 Insured Mail
Restricted Delive
0 C.O.D.
ry? (Extxa Fee)
DYes
2. ArtIcle Number
(Transfer from
serv/ce
label)
7004 2890 0004
2307 1049
PS
Form 3811, February 2004
Domestic Return Receipt
102595-02-M-1
540
