• U Complete items 1, 2, and 3. Also complete

tern

4

if Restricted Delivery is desired.

• Print your name and address on the reverse 7

so that we can return the card to you.

• Attach this

card

to the back of the mailpiec

or on the front if space permits.

1. Article Addressed to;

7/21/05

B .M.

AC 2005—028

Bill Wernigk

3585

East

3200 North Road

Potomac, IL 61832

RECEIVED

CLERK’S OFFICE

AU6O’~2OO5

ORIGINAL

STATE OF tLLINOIS

Poflutiofl Control Board

SENDER:

COMPLETE THIS SECTION

~5..s,jture

r7iYE.JJIsJa~rn:c~ Agent

—

(&~&~

0

Addressee

8. Received

Name)

C. Date of Delivery

rer~i&~nt~8r

e_-t--

~D.Is delivery address dIfferent from item 1?

0

Yes

?~ It YES, enter delivery address below;

C No

3. Spivice Type

~Sertifled

MaU

C

Express Mail

o Registered

0 Return Receipt for Merchandise

O Insured Mall

0 COD.

4. Restricted Delivery?

(Extra

Fee)

I Yes

2. Article Number

(Transferglum service label)

7004 2890 0004 2307 1407

PS Form 3811, February 2004

Domestic Return Receipt