REC~VED
-
CLERK’S OFHCE
iii:iii~
SENDER:
COMPLETE THIS SECTION
•
Complete items
1, 2, and
3. Also domplete
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.
•
Attach this card to the.backoVthe•mailpiece,
or~on
the front if space permits.
1.
Article Addressed to:
10/21
/
04
B
M.
PCB. 2004—015
Virgil T.
Harbach
Atkinson Grain
& Fertilizer,
Inc.
1006
S.
Quincy Street
Clinton, IL 61727
4.
Restricted
Delivery?
(ExtraFee).
2.
Article
Number
~7ransferfrornsèrv/ce/ebeO
7004
1160 0005 4126 3981
1 02595 02-M-1
54d~
NOV
082004
STATE OF ILLINOIS
Poflution Contro’ Board
3.
ServiceType
~~ertif
led
Mail
0
Express Mail
D.Registered
0
Return
Receiptfor Merchandise
0
insured Mail
0
C~O.D.
0
Yes
Form’381
1,
February 2004
borpestic RetUrn
Receipt