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Get Rural Customer Delivery Instructions

When parcels are left in one of the above checked locations I understand that the Postal Service and the carrier are not responsible in case of loss or damage. Option available only if residence is within 1/2 mile of carrier s route. Signature Date PS Form 4232 March 2010 Page 1 of 2 Previous Editions Not Usable Privacy Act Statement Your information will be used as instructions for delivering parcels to each person at your residence. We do not disclose your information to third parties without your consent except to facilitate the transaction to act on your behalf or request or as legally required. This includes the following limited circumstances to a congressional office on your behalf to financial entities regarding financial transaction issues to a U.S.Postal Service auditor to entities including law enforcement as required by law or in legal proceedings and to contractors and other entities aiding us to fulfill the service service providers. For more information regarding our privacy policy visit www. usps. com/privacypolicy. PS Form 4232 March 2010 Reverse. Option available only if residence is within 1/2 mile of carrier s route. Signature Date PS Form 4232 March 2010 Page 1 of 2 Previous Editions Not Usable Privacy Act Statement Your information will be used as instructions for delivering parcels to each person at your residence. Collection is authorized by 39 U.S.C. 401 403 and 404. Providing the information is voluntary but if not provided we may be unable to honor your parcel delivery preference. We do not disclose your information to third parties without your consent except to facilitate the transaction to act on your behalf or request or as legally required. This includes the following limited circumstances to a congressional office on your behalf to financial entities regarding financial transaction issues to a U.S.Postal Service auditor to entities including law enforcement as required by law or in legal proceedings and to contractors and other entities aiding us to fulfill the service service providers. Rural Customer Delivery Instructions See Privacy Act Statement on reverse. Your correct mailing address is shown below. Name Last First MI Box No* Telephone No* include area code Route No* Post Office State and ZIP 4 House No* Street Name Apt. No* We want to deliver your parcels. If your parcel does not require a signature for delivery and will not fit in your mail receptacle please tell us how you wish it to be handled when no one is home to accept delivery Check location Leave outside the mailbox Leave on the porch of residence To avoid delay and to assure prompt delivery of all mail please complete this form and return it to your carrier. Enter the name of each person who may receive mail at your address in the ten spaces provided below. Include the names of all children and/or employees. Print the full name including middle initial of each individual* This information will expedite delivery of your mail* Rural carriers maintain a supply of stamps cards and envelopes for sale.

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