COMPLETE THIS SECTION ON DELIVERY

B . eceived y

(Printed Name)

C D I

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 .

A . gnat

0 Agent

X0

ressee

D

s

0

4

. Restricted Delivery? (Extra Fee)

0 Yes

elivery

Article Addressed to :

4/19/07

PCB 2007-092

Dr .

Steve Fuerbach

12435 Bethany Rd .

Sycamore, IL 60178

I

12.

Article Number

(Transfer from service Iabel)

7006

0100 0000 7374 7743

PS Form 3811, February 2004

Domestic Return Receipt

B .M .

Is delivery address

different from Item 17

Yes

If YES,

enter delivery address below

:

0 No

Ice Type

(Fled Mail 0 Express

Mail

Registered

0 Return Receipt for

Merchandise

Insured

Mall

0 C.O .D.

10259502-M-1540

RECEIVEDCLERK'S

OFFICE

MAY 0 2 2007

OR/GINNA,

Pollution

STATE OF

Control

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