ORIGINAL

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

.

∎ Attach this card to the back of the mailpiece,

or on the front if space permits

.

1 1 . Article Addressed to:

7/6/06 B .M .

AC 2006-011

Robert C .

Wilson

P

.O . Box 544

i

117 West Poplar Street

Harrisburg, IL 62946

II

2. Article Number

I

(fiansrar hom service labep

COMPLETE THIS SECTION ON DE

:,LCR,

0 NoS

4

. Restricted Delivery? (Extra Fee)

0 Yes

ee

Ivory

Ps Form 3811, February 2004

7005 1160 0002 2067 9569

Domestic Return Receipt

RECEIVEDCLERK'S

OFFICE

JUL 2 4 2006

Pollution

STATE OF

Control

ILLINOISBoard

D

. Is delivery address different

If YES, enter delivery address below :

ce Type

ifled Mail 0 Express Mall

Registered

0 Insured Mail

0

Return Receipt for Merchandise

0 C.O.D .

102595-02-M-1500