ORIGINAL

SENDER:

COMPLETE THiS SECTiON

•

Complete items

1, 2,

and

3. Also complete

item

4 if Restticted Delivery is desired.

•

Print your name and addres&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.

Art~cleAddressedto:

6/2/05

B.M.

AC

2004—065

Jim

Roberts

Montgomery County State’s Atty.

Montgomery County Courthouse

120 North Main Street, Room 212

Hilisboro,

IL 62049

2.

Artk~le

Number

(rransfer

from

seil,ice

iab&)

RECEIVED

CLERK’S OFFICE

JUN

152005

STATE OF ILUNOIS

pollution ContrO’ Board

N.J

1

~,/MhI

~

0

Agent

7

lV~.-’(J

I’

-‘..-Vy

~

0

Addressee

p~rne

~

D.

Is

delivery

address different

from

item

1?

0

Yes

If YES, enter

delivery address below:

0

No

3.

Sejvlce Type

,~Pert~fledMail

0

ExpressMaiI

o

Registered

0

Return

Receipt for Merchandise

o

Insured

MalI

0

C.O.D.

4.

Restricted

Delivery? (Extra

Fee)

0 Yes

PS Form

3811,

February 2004

Domestic Return

Receipt

7004 2890 0004 2307

1001

1O2595-O2-M~1

$40