cVD
    CLERKS
    OFFICE
    OCT
    2
    i
    2Ofl
    STATE
    OF
    ILUNOIS
    Pollution
    Control
    Board
    •NDER:
    COMPLETE
    THIS
    SECTION
    Complete
    items
    1,
    2,
    and
    3.
    Also
    complete
    item
    4
    if
    Restricted
    Delivery
    is
    desired.
    B
    Print
    your
    name
    and
    address
    on
    the
    reverse
    so
    that
    we
    can
    return
    the
    card
    to
    you.
    B
    Attach
    this
    card
    to
    the
    back
    of
    the
    mailpiece,
    or
    on
    the
    front
    if
    space
    permits.
    1.
    ArticleAddressedto:
    10/16/08
    B.M.
    PCB
    2008—095
    1/1’
    7
    Charles
    F.
    Heisten
    Hinshaw
    &
    Culbertson
    100
    Park
    Avenue
    P.O.
    box
    1389
    Rockford,
    IL
    61105—1389
    A.7ture
    C
    rt
    jQ
    9
    C
    Addressee
    I
    .
    Re
    ved
    b,((Prin
    Name)
    0.
    Date
    of
    Delivery
    iery
    address
    differeritJr,
    item
    1?
    C] Yes
    1f
    4
    Dter
    delivery
    address
    below:
    C
    No
    3.
    S,ice4ype
    -
    &tified
    Mail
    C
    Express
    Mail
    Registered
    C
    Return
    Receipt
    for
    Merchandise
    C]
    Insured
    Mail
    C
    C.O.D.
    SENDER:
    COMPLETE
    THIS
    SECTION
    B
    Complete
    items
    1,
    2,
    and
    3.
    Also
    complete
    item
    4
    if
    Restricted
    Delivery
    is
    desired.
    B
    Print
    your
    name
    and
    address
    on
    the
    reverse
    so
    that
    we
    can
    return
    the
    card
    to
    you.
    B
    Attach
    this
    card
    to
    the
    back
    of
    the
    mailpiece,
    or
    on
    the
    front
    if
    space
    permits.
    1.
    ArticleAddressedt
    10/16/O,$
    PCB
    2008—095
    V
    7
    Nicola
    A.
    Nelson
    Hinshaw
    &
    Culbertson
    100
    Park
    Avenue
    -P.O.
    Box
    1389
    Rockford,
    IL
    61105—1389
    4.
    Restricted
    Delivery?
    (Extra
    Fee)
    C
    Yes
    2
    Article
    Number
    (rransferfronsicela
    7008
    C500
    0000
    45455’205
    PS
    Form
    3811,
    February
    2004
    Domestic
    Return
    Receipt
    102595-02-M-1540
    A.Sig
    re
    O
    Agent
    C
    Addressee
    B.
    Re
    ved
    by
    (Prin
    edWàme)
    C.
    Date
    of
    Deliveryt,
    C
    Yes
    C]
    No
    I
    diffeedt
    from
    item
    1?
    B
    .
    M.
    /‘
    delivery
    address
    below:
    ‘-
    -ee)ice
    Type
    ‘-eertifie&Mail
    []
    Registered
    0
    Insured
    Mail
    DExpressMail
    C
    Return
    Receipt
    for
    Merchandise
    CC.O.D.
    4.
    Restricted
    Delivery?
    (&t,a
    Fee)
    C
    Yes
    2
    Article
    Number
    (rransfer
    from
    service
    label)
    7008
    0500
    0000
    4545
    5212
    Domestic
    Return
    Receipt
    PS
    Form
    3811,
    February
    2004
    Ios9a-o2-M-1
    540
    /

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