RECEIVED
    CLERKS OFFICE
    001
    272005
    ORIGIN1
    STATEQFILLINO:S
    Pollution Control Board
    SENDER:
    COMPLETE THIS
    SLCTION
    COMPLETE THIS SECTION ON
    DEL (VEPY
    •
    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.
    NtlcleAddressedto:
    10/6/05
    n.M.
    AC
    2006—004
    Charles
    Tilley
    937
    South
    Street
    DuQuolu,
    IL
    62832
    2.
    Aitlcle
    Number
    (mnsferfivmsarAcelabofl
    7005 1160 0002 2069 3756
    A.
    x
    Signature
    Agent
    0
    Addressee
    B.
    ~
    Received by
    (
    Pflnted~
    1C.
    Date of Delivery
    1~cAt~
    /c/CL
    /O-~2f0i
    D.
    Is delivery address different from
    itØ
    I?
    0
    Yes
    If YES, enter delivery address below:
    0
    No
    3.
    Service Type
    ned
    Mall
    0
    Express
    Mail
    RegIstered
    0
    Return
    Receipt for
    MerchaMse
    0
    Insured
    Mall
    0
    C.0.D.
    4.
    RestrIcted
    Delivery?
    (&tm
    Fee)
    0 Yes
    PS
    Form
    3811,
    February 2004
    Domestic Return
    Receipt
    1 02595-02-M.1 540

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