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2, anj3.&s' complete <br />■ Print your name and amass oche reverse <br />so that we can return the card to you. <br />■ Attach this card to the back of the mailpiece, <br />or on the front if space permits. --r Y <br />1. Article Addressed to: <br />ATTN: OWNER/OPERATOR <br />KAISER PERMANENTE <br />7373 WEST LANE <br />STOCKTON, CA 95210 <br />Print Clearly) I B. Date of DQii�agr <br />Y� 0 U AN L[UUUU�I <br />C. Signature <br />X Agent <br />❑ Addressee <br />D. Is ress difkaXent from item 1? ❑ Yes <br />Zenterdelillepdres glow: ❑ No <br />1 P <br />3. Servv7w,- <br />><Certifiea Mail ❑ Express Mail <br />❑ Registered ❑ Return Receipt for Merchandise <br />❑ Insured Mail ❑ C.O.D. <br />4. Restricted Delivery? (Extra Fee) ❑ Yes <br />2. Article Number (Copy from service label) <br />7002 230 0001 7624 9540 <br />Form 3811, July 1999 Domestic Return Receipt 102595-00-M-0952 <br />