Health Net 2011 Annual Report Download - page 253

Once Employee has accepted the terms of this Release, Employee will have an additional seven (7) calendar days in which
to revoke such acceptance. To revoke, Employee must deliver or fax a letter of revocation addressed to: Organization
Effectiveness Unit, attention , (title) , (address). Such letter must be received by the
addressee within said seven (7) calendar day period. If Employee properly revokes, this Release will become null and void,
and Employee will receive no benefits under this Release. If Employee does not properly revoke, this Release will become
effective on the eighth (8th) calendar day following the date on which Employee signs this Release in accordance with this
Section 24.
EMPLOYEE ACKNOWLEDGES BY SIGNING BELOW that (i) Employee has not relied upon any representations, written
or oral, not set forth in this Release; (ii) at the time Employee was given this Release, Employee was informed in writing by
the Company that: (a) Employee had at least 21 calendar days in which to consider whether Employee would sign the Release;
and (b) Employee should consult with an attorney before signing the Release; (iii) Employee had an opportunity to consult
with an attorney and either had such consultations or has freely decided to sign this Release without consulting an attorney;
and (iv) Employee executes this Release knowingly and voluntarily.
IN WITNESS WHEREOF, the parties hereto have executed this Release as of the dates set forth below.
A-8
Employee Health Net, Inc.
By:
By:
Name: Name:
Title:
Dated:
Dated:
NOTE: Please return your signed waiver and release to:
Organization Effectiveness Unit
Attention: (Name, Title)
(Address, Cit
y
, State, Zi
p
Code)