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,

I

or on the front if space permits .

PS Form 3811, February 2004

Domestic Return Receipt

COMPLETE THIS SECTION ON DELIVERY

A. Signature

B

x

. Received

b

C_G

by (Printed"

rbdY)

~my

~~,ti,k

..

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C. Date of Delivery

D

(PCB 2004-107

( Bruce L

. Zumstein

I Codo, Bonds, Zumstein &

IKonzelmanNorth

Chicago Street

3 .

. Service fied

rtiged Mail O Express Mail

IJoliet, IL 60432

Registered

13 Return Recelpt for Merchandise

I

O

Insured mail

0

C .O.D.

4 Restricted Delivery? (Edra Fee)

C3 Yes

j 2 . Article Number

j

Mansferfromservice iabep

7005 1160 0002

2068 0251

1 1 Article Addressed to

:

9/7/06 B .M .

„O. Is delivery

Yes

delivery

from ow 1?

If YES, enter delivery address below:

RECEIVEDCLERK'S

OFFICE

SE P 2 2006

Pollution

STATE OF

Control

ILLINOISBoard

0 No

102595-02-M-1540 I