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SENDER: DELIVERY <br /> ■ Complete items 1,2,and 3.Also complete A. Sig ture <br /> item 4 if Restricted lie i ❑Agent <br /> ■ Print yow�h�� t reverse 11 Addressee <br /> so that e c U. B. Rec ived by(Printed Name) C.Date of Delivery <br /> ■ Attach th ac a ailpiece, ,� mjaleor on the front if space permits. <br /> 4=::2tva 112D. Is delivery address different from item 1? ❑Yes <br /> 1. Article Addressed to: If YES,enter delivery address below: ❑No <br /> KAISER PERMANENTE <br /> 7373 WEST LN <br /> STOCKTON CA 95210 3. Service Type <br /> ACertified Mail ❑Express Mail <br /> ❑Registered ❑Return Receipt for Merchandise <br /> ❑ Insured Mail ❑C.O.D. <br /> 4. Restricted Delivery?(Extra Fee) ❑Yes <br /> 2. (Transcle r Number <br /> 7004 2510 0003 3789 1952 <br /> (Transfer from service labeQ <br /> PS Form 3811,February 2004 Domestic Return Receipt 102595-02-M-1540 <br />