20072161 Ver 1_Certified Return Receipt_20071221

^ Complete items 1, 2, and 3. Also complete
item 4 if Restricted Delivery is desired.
^ Print your name and address on the reverse
so that we can return the card to you.
^ Attach this card to the back of the mailpiece,
or on the front if space permits.
Article Addressed to:
Rutherford Electric Membership
Attn; J. Wortman
Y.O. Box 1569
Forest City,NC 28043
DWQ# 07-2161-Poll<
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A. ,$i at re
X" ~ ^ Agent
^ Addressee
B. Rec ived by (Printed N e) .Date of Delivery
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D. Is delivery address different from em 1? ^ Yes
If YES, enter delivery address below: ^ No
3. Service Type
^ Certified Mail ^ Express Mail
^ Registered ^ Return Receipt for Merchandise
^ Insured Mail ^ C.O.D.
4. Restricted Delivery? (Extra Fee) ^ Yes
2. Article Number
(Transfertromservics 7007 256 ~021~~1381 582
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UNITED STATES;;~i~~~+'.~.Fc~~~~~I, `t~Ji:.: .,~:~'? ` ~ r~t~ i7'+ F~f~~iI-CHB~'$,T~ai~
'~:~ " " ~~s;~ &~ees Paid
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• Sender: Please print your name, address, and ZIP+4 in this box •
NC DLNR Division of Water Quality
401 Oversight/Express Unit
2321 Crabtree Boulevard, Suite 250
Raleigh, NC 2760
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