Mailing Service Request Form

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Mailing Service Request Form

PLEASE PRINT AND FILL OUT COMPLETELY

ORIGINATOR INFORMATION
TODAY'S DATE:______________________________________
CHARGEABLE COST OR RESPONSIBILITY CENTER:____________________
YOUR NAME:______________________ TELEPHONE EXT:_______________

DESTINATION INFORMATION

TO:_______________________________________________________________________(COMPANY OR AGENCY NAMES)

ATTN:__________________________________________________________________________(INDIVIDUAL'S NAME)

STREET:________________________________________________________________________(Must be given fro all countries - only USPS can deliver to box numbers or Rural Routes)

CITY:_________________________________

STATE OR COUNTRY:_____________________ ZIP OR ZIP + 4:___________________

VALUE:______________________________________

DELIVERY NEED LEVEL (PLEASE CHECK ONE)

Up to 3 days_____ Next Working Day by Noon_____
2nd Working Day____ Next Working Day Before Noon______
Next Working Day ______ Next Workind Day by 3:00pm _______

For Mail Services Use Only

Number of pieces _______________ Total Postage________________

Mailing Service Request Form