REC~VED
CLERK’S OFRCE
~~~NJA~L
STATE OF ILLINOIS
PolIut~oflControl Board
SENDER:
COMPLETE THIS SECTION•
COMPLETE THIS SECTION ON
DELIVERY
•
Complete items 1, 2, and 3. Also complete
item
4 if Restricted Delivery is
desired.
1
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.
I.
Article
Addressed to:
11/ 4/04
B. M.
PCB
2001—043
David N.
Stone
Ncl-Ienry State’s Attorney Office
2200 North Seminary Avenue
Woodstock,
IL 60098
A.
Signature
o
Agent
o
Addressee
B. Received by
(Printed
Náme~f
C.
Date bf
Delivery
D.
Is delivery address
differentfrornitem1.?
0
Yes
If
YES, enter deliveryaddress
below:
0
No
3.
Sprvice Type
ertified
Mall
Registered
0
Insured Mail
.0
Express Mail
o
Return
Receipt for Merchandise
o
c.o,b.
4J
Restricted
Delivery?
(~Extra
Fee)
DYes
2~
Article Number
~rransferfromseiviceIabeQ
70041.160
0005
4126
0676
PS Form
3811,
February 2004
Domestic Return
Receipt
102595-02-M-l$40