SENDER: COMPLETE THiS SECTIONI Complete items 1, 2, and 3.
Also complete
item 4 if Restricted Delivery is desired.
• Attach this card to the back of the mailpiece,.
c~ron the front if space permits.
B.
M,7
RECEIVEDCLERK’S OFFICEMAR -32005STATE OF ILLINOISPollution Control BoardA. Signet~ 0 Addressee~ecelved by (Printed Name) . C. Da of eliveryI). Is deliveryaddress different from item 1? 0 YesIf YES, enter delivery address below:. 0 NoDieterich, IL 62424 .3. S~MceType~ertlf led Mail 0 Express Mail,D Register~d. 0 Return Receipt for Merchandise0 Insured MalI 0 C.O.D.4. Restricted Delivery?
Allowed
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