SENDER:

COMPLETE THIS SECTION

COMPLETE THIS SECTION ON DE ERY

/10 Addre

O Addressre

O

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n

C . Dar f

A L

ery

D

J -7

∎ 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 cleAddressedto:

4/19/07

B .M .

PCB

2007-037

Charles

Knoche, Village Presiden

Village of Dorchester

Village Hall

1100 Jermain

IDorchester, IL 62033

2 . Article Number

(Transfer

fromservice labeq

70060100 000073747712

PS Form 3811, February 2004

Domestic Return Receipt

Is delivery address different from item

13 es

If YES, enter delivery address below

0 No

3

. Service Type

1kertifled

93

RegisteredMail

0 Express Mail

0 Insured Mail

0 Return Receipt for Merchandise

0

C.0 D .

4

. Restricted Delivery? (Extra Fee)

0 Yes

102595-02-M-1640 :

RECEIVEDCLERK'S

OFFICE

MAY

1

1 2007

Pollution

STATE OF

Control

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