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 : 3/15/07 B

.M .

AC 2007-033

j Perry D

. Winebrinner

1 1010 Pulaski Street

I Lincoln, IL 62656-3136

'. Article Number

trransferfromsemicelabe/

7001 1140 0002 7469 0213

Corm 3811,

February 2004

RECEIVED

CLERK'S OFFICE

MAR 2

9

2007

Pollution

STATE OF

ControlILLINOISBoard

Domestic Return Receipt

D

O Agent

O Addresse

C Date f Deli

3 z o

Is

ery address different from Item 1?

11 Yes

If YES, enter delivery address below:

0 No

Ice Type

Certified Mail O Express Mall

Registered

0 Return Receipt for Merchandis

0 Insured Mail

0 C.O.D .

4 Restricted Delivery?

(Extra Fee)

CLERKS

ni=p-7C-~

y

Pollution

STAT't

Control

OF

ILL ;,

Boa,

..' ;

a

0 Yes

102595.02-10-151