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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