OR I FINAL

SENDER :

COMPLETE THIS SECTION

COMPLETE THIS SECTION ON DELIVERY

•

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 .

Article Addressed to

4 / 19/07

B .M.

AC 2007-044

Harold Tomlinson

Box 7

104 Parkview Circle

Washburn, IL 61570

II

2 . Article Number

(Transfer fmmservice labe9

7001 1140 0002 7489 2574

I PS Form 3811, February 2004

Domestic Return Receipt

102595-02-M-1540'

RER

'S OFFICE

MAY 0 1 2007

Pollution

STATE OF

Control

ILLINOISBoaro

A. Si atue,

~~O

Agent

~ Ad dressee

B Received

by (,~nnf d Name)

C

. Date of eliv

V ALrlskwLrl~

.°U1 C 7

D

. Is elivery address different from item I? O Yes

If YES, enter delivery address below:

O No

Ice Type

rtified Mail

O Express Mail

Registered

D Return Receipt for Merchandise

D Insured Mall

0 C.O.D .

4 . Restricted Delivery? (Extra Fee)

0 Yes