Complete items 1, 2,
and 3. Also complete
item
4 if Restricted Delivery is desired.
a
Print your name and address
on the reverse
so that we can return the card to you.
a
Attach this can~
to the
back of the mailpiece,
or on the front~Tfspace permits.
I.
ArticleAddressedto:
4/21/05
AC 2005—058
Lomac Payton
Knox County Landfill Committee
Knox County Courthouse~
Galesburg, IL 61401
REcE~v~
CLE1~K’S
OFFICE
MAY022005
STATE
OF
POllUtion
B~R~ceived
by
(Printed Name)
C.
Date of Delive
/
0.
Is deliveryaddress different
frem
item 1?
0
‘tes
IfYES, enter delivery address below~
9
No
3.
Service Type
~,Qertified
Mail
O
Registered
0
Express Mail
0
Return
Receipt for Merchandise
o
Insured Mail
0
C.O.D.
0 Yes
SENbER:
COMPLETE THIS SECTION
COMPLETE THiS SECTION ON DELIVERY
A.
Signature
o
Agent
o
Addressee
/
4.
Restricted Delivery?.
(Extre
Fee)
2.
Article Mumber
çrransfer from service
(abel)
7004
2890
0004
2296
4762
PSForm
3811,
February 2004
Domestic Return
Receipt
102595-02-M-1
540