ORIGINAL

SENDER :

COMPLETE THIS SECTION

∎ Complete items 1, 2, and 3. Also complete

Item 4 N Restricted Delivery Is desired .

t Printyour name and address on the reverse

H

so that we can return the card to you

∎ Attach this card to the back of the mailpiece,

oron the front If space permits .

1. Article Addressed to :

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I

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A. Signature

4. Restricted Delivery? (Extra Fee)

RECEIVED

CLERKS OFFICE

MAY 0 1 2006

STATE OF ILLINOIS

Pollution Control Board

COMPLETE THIS SECTION ON DELIVERY

B. Received

by (PrintedName)

C. D

of Delivery

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&ld

4rA

.

Oqa7

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16

-

D . Is delivery address different from Item 1? O Y

If YES, enter delivery address below:

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4/20/06 B .M .

AC 2006-026

Mar%hall and Juanita Gdtrigon

21977 North Krupp Lane

Centralia, IL 62801

ce Type

tried Mao

0

Express Mall

Registered

0

Return Receipt for Merchandise

0

Insured Mall

0 C.O.D .

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1

2. Article Number

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masferf

mservicelaben

7005 1160 0002 2067 8982

0 Yes

I PS Form

3811,

February 2004

Domestic Return Receipt

1o2595-02-M-1570