SENDER : COMPLETE THIS SECTIOrV

∎ 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 mailplece,

or on the front if space permits .

1

. Article Addressed to : 10/5/06 B .M.

AC 2007-006

Richard Deibel

I

804 Glenwood

Effingham, IL 62401

2 . Article Number

(rranarerfrom service iabel)

7005 1160 0002 2068 0442

j PS Form 3811, February 2004

starved by

to

RECEIVEDCLERK'S

OFFICE

OLI

3 3 2006

Pollution

STATE OF

Control

ILLINOISBoard

COMPLETE THIS SECTION ON DELIVERY

A

/

t0

D. Is delivery address

delivery

different from o 1?

N

If YES, enter delivery address below

:

C No

o

4 . Restricted Delivery? (Extra Fee)

C Yes

3

. Service Type

Certified me(( O Express mail

17

Registered

C Return Receipt for Merchandise

C Insured Mall O C.O.D .

Domestic Return Receipt

102595-02-b1.154o