| SENDER: COMPLETE THiS SECTiON • Complete items 1, 2, and 3.item 4 if Restticted Delivery is desired.- • Attach this card to the back of the mailpiece,
or on the front if space permits.- Montgomery County Courthouse
120 North Main Street, Room 212Hilisboro, IL 620492.(rransfer from seil,iceiab&) RECEIVEDCLERK’S OFFICEJUN 152005STATE OF ILUNOISpollution ContrO’ BoardN.J 17~,/MhIlV~.-’(J~ I’ -‘..-Vy ~ 0 AgentAddresseep~rne ~ D.- Is delivery address different from item 1? 0 Yes
If YES, enter delivery address below: 0 N... |
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