•
    Complete items 1,
    2, and 3. Also complete
    item 4
    If Restricted Delivery is desired.
    •
    Pnnt 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.
    1.
    ArticleAddressedto:
    7/22/04
    B.M.
    AC 20O4-’~&5
    Ms. Carol A. Schenk
    Estate of Roy G. Frietsch
    5800 S. Adams
    Bartonville, IL 61607
    I).
    Is delivery
    address different from Item 1?
    0
    Yes
    If YES, enter delivery address
    below:
    0
    No
    CLERK’S OFFiCE
    AUG
    -2
    2004
    STATE
    OFILIJNOIS
    Pollution Controi Board
    A.
    Sign
    ure
    I
    DAgent
    ~
    Addressee
    ,Aecelved by
    (Pnntad Name)
    C.
    Date
    of Delivery
    /
    3.
    Service Type
    ~ertified
    Mail
    D
    RegIstered
    0
    Express Mail
    0
    Return
    Receipt for Merchandise
    0
    Insured
    Mail
    0
    C.O;D.
    4.
    RestrIcted Delivery?
    (Extre Fee)
    0
    Yes
    2.
    Article
    Number
    ~ns~,làeIabeO~
    7oo2203O~ao04~55z3
    9O57~
    PS Farm
    3811,
    AugUst 2001
    bon~estióReturn Receipt
    102595-0244-1 540

    Back to top