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

that we can return the card to you.

ch this card to the back of the mailpiece,

n the front If space permits .

10/5/06 B.M

.

007-009

Ch rles F . Kinsel

14998 North Shelby Road

Lewistown, IL 61542

sed to

ORIGINAL

COMPLETE THIS SECTION ON DELIVERY

x

RECEIVED

CLERK'S OFFICE

OCT 1 b 2006

STATE OF ILLINOIS

Pollution Control Board

A. Signature

0 Agent

A

0 Addressee

B. Received by (Printed Name)

C . DD~~eIl ery

D

. Is

(E(Idc\

delivery address

VI

different

nPe

from item 1? 0 Yes

If YES, enter delivery address below :

0 No

Ice type

riffled Mall 0 Express Mail

Registered

0 Return Receipt for Merchandise

0 Insured Mall

0 C.O.D.

1

4

. Restricted Delivery? (Extra Fee)

1

2 . Article Number

(rransferfrom servlcelabel)

7005 1160 0002 2068 0480

PS Form 3811, February 2004

Domestic Return Receipt

102595-02-M-1540

0 Yes