ORIGINAL

SENDER : COMPLETE THIS SECTION

∎ Complete

item 4 if

items

Restricted

1, 2,

Delivery

and 3

.

Is

Also

desiredcomplete

.

•

so

Print

that

your

we can

name

return

and address

the card

on

to

the

youreverse

.

•

Attach

or on the

this

front

card

if

to

space

the back

permitsof

the

.

mailpiece,

1

. Article Addressed to: 10/19/06 B

.M .

AC 2006-050

Mark Lewis Gates

323 Decatur Street

Lincoln, IL 62656

I

A ign

x

2. Article Number

i

(Ransferfrom service label)

7005 1160 0002 2068 0503

I PS Form 3811, February 2004

Domestic Return Receipt

RECEIVCDCLERK'S

OFFICE

ru

2006

STATE OF ILLINOIS

Pollution Control Board

COMPLETE THIS SECTION ON DELIVERY

O Agent

O Addressee

C. Date of Delivery

/0

. 3o-sG

D. Is delivery address different from item 17 0 Yes

If YES, enter delivery address below

:

0 No

B Received by (Printed Name)

Ice

rtifled

Type

Mall 0 Express Mail

O Registered

O Return Receipt for Merchandise

0 Insured Mail

0 C.O.D .

4. Restricted Delivery! (Extra Fee)

0 Yes

102595-02-M-1540