ORIGINA L

SENDER

: COMPLETE THIS SECTION

∎ Complete items 1, 2, and 3

. Also complete

j

item 41f Restricted Delivery Is desired .

∎ Print your name and address on the reverse

so that we can return the card to you .

1 ∎ Attach this card to the back of the mailpiece,

or on the front if space permits .

I i1 . Article Addressed to :

10/5/06 B

.

AC 2007-006

1 Brian Hayes

1713 South Willow St .

i

Effingham, IL 62401

I

I

RECEIVED

CLERK'S OFFICE

OCT 1 9 2006

Pollution

STATE

OF

ILLINOISi3o

COMPLETE

T,IltS SECTION ON DELIVERY

AA

re

X

O

0 AddresseeAgent

(Z

rad r C C J

. 7aof

, ~ livery

D . Is delivery address different from item 1?

0 Yes

If YES, enter delivery address below

:

0 No

4

. Restricted Delivery? (ExBa Fee)

2 . Article Number

(Transfer from service label)

I PS Form 3811,

February 2004

7005 1'160 0002

2068 0459

Domestic Return Receipt

0 Yes

I

102595-02-M-1540

3 .

Ice Type

ifled mail 13 Express map

Registered

l7

Return Receipt for Merchandise

0 Insured Mall 0

C.O .D .