1. page 1

 
ORIGINA
L
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,
or on the front if space permits .
1 Article Addressed to:
1/26/07 B .M .
PCB 2007-035
Jason P . Stone
Lewis & Longlett
435 Hampshire Street
Quincy, IL 62301
2. Article Number
(rransforfromserv/celabel)
7001 1140 0002 7469 0817
PS Form 3811, February 2004
Domestic Return Receipt
RECEIVED
CLERK :S OFFICE
FE 5 2007
STATE OF ILLINOIS
pollution Control Board
COMPLETE THIS SECTION ON DELIVERY
B . Recelved by (Printed Nants)
D
D Agent
13 Addressee
JMte ofDelivety
Is delivery address different from ml?
0 Yes
If YES, enter delivery address below :
El No
3. ~So ice Type
"L/
f
pertNled
RegisteredMall
0 Express Mall
O Insured Mall
O Return Receipt for Merchandise
0 C.O.D
.
4. Restricted Delivery? (Extra Fee)
0 Yes
102595-02-M-1500 ;
i

Back to top