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• Complete items 1, 2, and 3.item 4 if Restricted Delivery is desired~I Print your name and address on the reverseso that we can, return the card to you.- 1.
- ArticleAddressedto: 11/4/04 B.M.
- PCB 2001—043
Michael Stringini1108 S.Schaumburg, IL 60193 RE~~VEDCLERK’S OFRUENOV 2 92004STATE OF ILUNOISPollution Contro$ BoardA;Signature 0 Agent ~ Addresseeb~Received by ( dnte,~,yt~) ~ D. Is deliveryaddress different ftom~tem1? (Extra Fee) 0 yes2. Article Number(Transferfromseivice/abel) 7004 1160 0005 4126 0683... |