CLERK’S OFFICE
    FE~
    113
    2005
    STATE OF ILLINOIS
    PoII~t
    ion Control Board
    SENDER
    COMPLETE THIS SECTION
    1
    COMPLETE THIS SECTION ON
    DELIVERY
    •
    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:
    1/20/05
    B.N.
    AC 2005—036
    Leland Cole
    6408 Reinder
    Springfield,
    IL 62707
    9
    Express Mail
    o
    Return
    Receipt for Merchandise
    O
    COD.
    4.
    Restricted
    Delivery?
    (Extra
    Fee)
    0
    Yes
    2.
    Article Number
    (Transfer
    from service label)
    7004 0750 0004 3960 2564
    A.
    Signature
    x
    0
    Agent
    If
    YES, enter delivery address below:
    •es
    0
    No
    3.
    Service Type
    o
    Certified Mail
    o
    Registered
    o
    Insured Mail
    PS Form
    3811
    February 2004
    Domestic Return
    Receipt
    1 02595-02-M-1 540

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