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ORIGINAL
SENDER : COMPLETE THIS SECTION
I
โˆŽ Complete items 1, 2, and 3 . Also complete
I โˆŽ Print
Item 4
your
If Restricted
name and
Delivery
address
Is
on
desiredthe
reverse
.
l
so that we can return the card to you .
I
i โˆŽ Attach this card to the back of the mailplece,
or on the front if space permits .
1 1 . Article Addressed to:
8/4/06 B .M .
` AC 2006-052
Charles L
. Riggins
10364 N . CR 2800 E
Easton, IL 62633
4
V i
13 Yes
A. Signature
x
vl
C] Agent
13 Addressee
C. Dat
DeIN
Is delivery address
from en 1?
YES, enter delivery address below :
O No
o
Yes
i
I
2. Ankle Number
(transfer from service labeQ
i
PS Form 3811, February 2004
7005 1160 0002 2067 9880
Domestic Return Receipt
RECIEIIVEDCLERK'S
OFFICE
AU
2 3 2006
STATE OF ILLINOIS
Pollution Control Board
COMPLETE THIS SECTION ON DELIVERY
Ice Type
ided Mad C Express Mail
Registered -
C Return Receipt for Merchandise
13 Insured Mall
(3 C .O .D .
4 . Reslrlcted,I)eiwery? (Extra fee)
102595-02-M-1,ยข,80

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