f

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,

I

or on the front if space permits

.

1 . Article Addressed to:

AC 2006-038

William Slane

129

Lamard

St .

Geff, IL 62842

ORIGINAL

.

7/6/06 B .M .

2 . Article Number

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. .,

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2067 9606

PS

Form

38.

C

_

eturn Receipt

RECEIVED

JUL 2 4 2006

pollution

STATE OF

Control

ILLINOISBoard

COMPLETE THIS SECTION ON DELIVERY

A . Signature

X

O Agent

0Addressee

B . Received by (Printed Name)

C. Date of Delivery

D

rA(

. Is delivery

ccc

address

/. .

different

-5fc

from

~

Item 1?

0

Yes

If YES, enter delivery address below :

11

No

3 . S Ice Type

Wiled Mail

13 Express Mall

Registered

0 Return Receipt for Merchandise

11 Insured Mail

0 C.O D .

4. Restricted Delivery? (Extra Fee)

0

Yes

102595-02-10-1540