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ORIGINA L
SENDER : COMPLETE THIS SECTION
∎ 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 .
1 ∎ Attach this card to the back of the mallpiece,
I
or on the front If space permits .
1 . Article Addressed to:
5/4/06 B .
I PCB 2004-106
I
Keith I . Harley
I Chicago Legal Clinic
205 West Monroe Street
4th Floor
I
Chicago, IL 60606
I
12 . Article Number
I
(rransferfromservice label)
7005 1160 0002 2067 9156
Ps Form 3811, February 2004
Domestic Return Receipt
COMPLETE THIS SECTION ON DELIVERY
r
0 . Is delivery address different from Item 19 0 YesAddressee
If YES, enter delivery address below :
0 No
a Service Type
`4CertRled
b
RegisteredMall
13
Express Mail
0 Return Receipt for Merchandise
0 Insured Mail
0 C.O.D .
4 . Restricted DeliveM (Fate Fee)
0 Yes
RECEIVED
CLERK'S OFFICE
MAY I L 2006
STATE OF ILLINOIS
Pollution Control Board
102595-02-WI540

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