CLERK’S OFFICEPollutionSTATEFEB OFControl142005ILLINOISBoardSENDER COMPLETE THIS SECTION COMPLETE THISSECTION ON DELIVERYa Complete items 1, 2, and 3.
Also complete A.
Sign~ture
item 4 if Restricted Delivery is desired.
~~eceived by (Printed Name) C.
Dateof Delivery
a Attach this card to the back of the mailpiece,or on the front if spacepermits.
d/b/a
Riverland FS, Inc. ______________________________3. Service Type686 Depot Street th~CertifiedMail 0 Express MailWataga, IL 61488 b Registered 0 Return Receipt for Merchandise0 Insured Mail 0 C.O.D. - ...
Allowed
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