\

RECEIVED

CLERK'S OFFICE

DEC 2 6 2007

STATE OF ILLINOIS

Pollutfo

r

, Control Board

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 mailplece,

or on the front If space permits.

1. Article Addressed to:

12/20/07 B.

AC 2008-008

James and Mildred Taviner

1004 Fowler Road

P.O. Box 498

Hardin, IL 62047-0498

A. Signature

q

Agent

q

Addressee

C? ry

a

of

B. Received by

(Printed Name)

e of/Delive

lot

D. Is delivery address different from item 1?

q

Yes

If YES, enter delivery address below:

?

q

No

Ice Type

teed Mall

q

Express Mall

Registered

?

q

Retum Receipt for Merchandise

q

Insured Mail

?

q

C.O.D.

4. Restricted Delivery?

(Extra Fee)

?

q

Yes

x

ef4 -/"A vi ne.g

2. Article Number

(Transfer from service label)

7006 0810 0004 2225 2201

PS Form 3811, February 2004

Domestic Return Receipt

102595-02-M-1540 !,