1. Page 1

 
qEOEIVED
CLERIC'S
OFFICE
APR 1 4 2008
6TA
T
E
OF
ILLINOIS
p
ollutio
n.
Control Board
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.
1. Article Addressed to:
4/3
/08 B.M.
PCB 2008-060''
Mark Van Holton
19170 Rush Road
Lyndon, IL 61261
3.
Service Type
ified Mail
q
Express Mail
'
Registered?
q
Retum Receipt for Merchandise
0 Insured Mail
?
q
C.O.D.
4. Restricted Delivery?
(Extra Fee)?
q
Yes
COMPLETE THIS SECTION ON DELIVERY
Sign
A.
Si n
elved py (Tr)ted
N
vsK, vete
C. Date of Delivery
L1-1
D. Is delivery address different from item 1?
q
Yes
If YES, enter delivery address below: ?
q
No
q
Agent
q
Addressee
2. Article Number
(Transfer from service labe0
7007 3020 0000
4630 5890
PS Form 3811, February 2004
Domestic Return Receipt
102595-02-M-1540

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