0

IUINAI

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,

I

or on the front if space permits .

I

II

II

I

I

1

. Article Addressed to:

3/15 07 B .M .

PCB 2006-079

Kevin A . Polo

207 North Macoupin

Gillespie, IL 62033

2. Article Number

(riansrerfrom service label) 7001 1140 0002 7469 0268

1 PS Form

3811, February 2004

Domestic Return Receipt

COMPLETE THIS SECTION ON DELIVERY

E ue

0 Agent

~ Addressee

B

. calved by (Printed N

C

. Date of Dellven,

3 -,?!;-07

D

. Is delivery address different from item 1?

0 yes

If YES, enter delivery address below :

0 No

3. Service Type

Certified Mail 0

Express Mail

Registered

0

Insured Mail

0 Return Receipt for Merchandise

0 C.O.D.

4. Restricted Delivery? (Extra Fee)

RECEIVEDCLERK'S

OFFICE

MAR 2 6 2007

Pollution

STATE OF

Control

ILLINOISBoard

0

Yes

102595.02-M

.154