SENDER:

COMPLETE

THIS

SECTION

•

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.

•

,ch

this

card

to

the

back

of the

mailpiece,

the

front if

space

permits.

1

Aicle Addressed

to

9

/

4

/

08

B

M

PCB

2006—j16

Halleck

Warren

11021

West

96th

Terrace

Overland

Park,

KS

66214

CLERK’S

OFFICE

SEP’22

2008

STATE

OF

ILlINOIS

pollution

Control

Board

i*1L•JA

•h!I’J4lV’i:1’

Agnature

B.

Rec

ed

by

(

nted

Name)

C.

Date

of

Delivery

Is delivery

address

different

from

item 1?

0

Yes

If

YES,

enter

delivery

address

below:

0

No

3. Service

Type

‘Dertified

Mail

0

Express

Mail

IJJ

Registered

0

Return

Receipt

for

Merchandise

0

Insured

Mail

0

CO.D.

4.

Restricted

Delivery?

(Extre

Fee)

0

Yes

2. Article

Number

(Transferfrom

serilce

label)

7007

3020

0000

4630

7283

PS1Frn

381

1

Fbniy

2004

1

1

1

çmestic

Return

Receipt

iO2595O2-M-154O