ORIGINAL
SENDER : COMPLETE THIS SECTION
∎ Complete items 1, 2, and 3. Also complete
item 4 it 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 ArtlcleAddrassedto:
1/5/06
B .M .
PCB 2005-103
William D . Seith, Esq .
631 E
. Butterfield Road
Suite 315
Lombard, IL 60148
RECEIVEDCLERK'S
OFFICE
JAN 2 7 2006
Pollution
STATE OF
Control
ILLINOISBoard
COMPLETE THIS SECTION ON DELIVERY
by (Pnnteq
D. Is
y
delivery
,
10
address
-
&&
different
4
from item 17 0 Y
If YES, enter delivery address below : 0 No
3 Serv
. Type
Mao 0 Express Mall
Registered
0 Return Receipt for Merchandise
0 Insured mail
0 C.O.D.
4 . Restricted Delivery? (atm Fee)
A. Signature ;
2 . Article Number
>
abari
7005 1160 0002 2443 1385
1025002a4-1sw