Laserfiche WebLink
■ Complete items 1, 2, and 3. Also complete <br />item 4 if Restricted Delivery is desired. <br />■ Print your name and address on the 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. <br />1. Article Addressed to: <br />SAINI, SURINDER SINGH <br />508 W CHAPTER WAY <br />STOCKTON CA 95206 <br />2. Article Number <br />(Transfer from service label) <br />IPS Form 3811, August 200f <br />A. Signat <br />X ❑ Agent <br />❑ Addressee <br />B. ei .nted Name) C. Da of Delivery <br />U <br />f <br />D.'64 address different from item 1 . Yes <br />Y nter delivery, ad <br />,C� ai jC <br />V 1 9 2004 <br />3. Serrvic vp {J,�f i:NT HEALTH <br />M,C,rtified Mail ❑Fpress <br />❑ Registered ❑ Retul►'ppCE16ndi <br />se <br />❑ Insured Mail ❑ C.O.D. <br />4. Restricted Delivery? (Extra Fee) ❑ Yes <br />7003 3110 0003 5254 3357 <br />Domestic Return Receipt 102595-01-M-2509 <br />