1. page 1

 
ORIGINAL
.
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 :
3/15/07
B .M
PCB
2005-216
Wayne Haser
125763 Will creek Lane
RECEIVED
Monee, IL 60449
OR
CLERK'S OFFICE
MAR 2 8 2007
Pollution
STATE OF
Control
ILLINOISBoard
I
2 . Article Number
(Transfer from service
label)
I PS Form
3811, February 2004
COMPLETE THIS SECTION ON DELIVERY
a
11 Agent
dresses
ce T
0 Express Mail
_ .
0 Return Receipt for Merchandlsr
cured
I
0 C.O .D .
7001 1140 0002 7469 0374
Domestic Return Receipt
Delivery? (Extra Fee)
C . Date of Deliven,
ery address d event from item 1?
O Yes
delivery address below:
O No
0 Yes
i
102595-02-M-154

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