1. Page 1

 
SENDER:
COMPLETE THIS SECTION
RECEIVED
CLERK'S OFFICE
MAR 31 2008
STATE OF ILLINOIS
Pollution Control Board
COMPLETE THIS SECTION
ON
DELIVERY
Complete items 1, 2, and 3. Also complete
Rem 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: 3/20/08 B.M.
AC 2007-054
Adolph M. Lo
906 W. Curtis Road
Champaign, IL 61821
A. Sign
X
D. Is delivery address different from item 1?
q
Yes
If YES, enter delivery address below:
?
q
No
ice "Ripe
Mall
q
Express Mall
?
Registered?
0 Return Receipt for Merchandise
?
0 Insured Mall?
q
C.O.D.
4. Restricted
Delivery?
(Extra
Fee)
?
q
Yes
2. Article Number
(Transfer from service label)
7007 3020 0000 4630 5302
PS Form
3811,
February 2004
Domestic Return Receipt
102595-02-M-15
SENDER:
COMPLETE THIS SECTION
■ Complete Items 1, 2, and 3. Also complete
Item 4 it 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:?
3/20/08 B.M.
AC 2007-054
Harold A. Miller
Miller & Hendren
P.O. Box 980
Champaign, IL 61824-0980
COMPLETE THIS
SECT/0/1,
ON DELIVERY
.
:471,Frt&
_ ?
0 Agent
q
Addressee
A.
Si
X
B. Received by
(Printed Name)?
C. Date of Delivery
Is delivery address different from item
3-2
1?
q
Yes
7
-0
If YES, enter delivery address below:
?
q
No
3. Service Type
Med Mall
q
Express Mall
Registered?
q
Return Receipt for Merchandise
q
Insured Mail?
q
C.O.D.
4. Restricted Delivery)(Ertra
Fee)
?
q
Yes
2. Article Number
(Transfer from service label)
7007 3020 0000 4630 5319
PS Form
3811, February 2004?
Domestic Return Receipt
?
102595.02-M

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