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
..
v*
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