CL~EF~K’$
OFFICE
NOV
C
120114
STATE OF ILLINOIS
Pollution Controi Board
A.
Signature
x
~7.
~/
~1k&n_~
0
Agent
0
Addressee
B.
Received by
(Printed Name)
C.
Date of Delivery
/
ce
~7~Thn,
0.
Is deliveryaddress different fronTheTn~
Li
Y.~U(I4
IfYES, enter delivery address below~
0
No
3.
~
ServiceType
,~CertifledMalI
o
Registered
0
Express Mail
0
Return
ReceiPt fOr Merchandise
o
Insured Mail
0
0.0.0.
.
SENDER:
COMPLETE THIS SECTION
•
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:
10/21/04
B.M.
PCB 1996—010
David M.
Allen
Schuyler, Roche
& Zwirner
One Prudential Plaza
130
E.
Randolph Street, Suite
38C
Chicago,
IL 60601
2.
Article Number,
~Transfer
from
sèni1ceIabeI~)
7004
1160
0005
4126, ~
4. ~Restñcted
Delivery?
(Extra
Fee)
DYes
PSForm’381
1,
February 2004
Don~esticRetUrn Receipt
102595-02-M4540