CLERK’S OFFICE
    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.
    •
    Attach this card to the back of the mailpiece,
    or on the front if space permits..
    1.
    ArticleAddressedto:
    10/7/04
    B.M.
    PCB 2001—007
    Heidi
    E. Hanson
    H.E.
    Hanson, Esq. P.C.
    4721 Franklin Avenue,
    Ste.
    15.00
    Western
    Springs,
    IL 60558—1720
    OCT
    18
    2004
    STATE OF
    ILEJNOIS
    PoIlut~onControl
    Board
    A.
    Signature
    B. R~ei~ed
    by
    (
    Pun ed Namé~l
    C.
    Date of Delive
    ~
    D.- Is delivery address
    different
    fron~
    item 1?
    0
    Yes
    If YES, enter delivery address
    below:
    0
    No
    3.
    Service
    Type
    ~QbrtIfied
    Mail
    ‘tJ
    Registered
    0
    Insured Malt
    0
    Express.
    Mail
    0
    Return
    Recei
    DC.O.D.
    pt for Merchandise
    ~.
    SENDER:
    COMPLETE THIS SECTION
    COMPLETE THIS SECTION ON DELIVERY
    o
    Agent
    Addressee
    4.
    Restr~cted.
    Delivery?
    (&t,~a
    Fee)
    0
    yes
    2,
    A~tide
    Number
    (rransferfrom.ser,fcelabeO
    7002 0860 0004 9617 9960
    PS
    Eorm~381
    1,
    February ~OO4
    Domestic Return
    Receipt
    iO2595~O2~M-1S4O

    Back to top