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Get USPS PS 3575 2008-2021

Sign PS FORM 3575 MAY 2008 Visit usps. com to change your address online or call 1-800-ASK-USPS 1-800-275-8777 NOTE The person signing this form states that he or she is the person executor guardian authorized officer or agent of the person for whom mail would be forwarded under this order. If mailing the form below put in envelope and address as follows Remember to apply First Class postage TO POSTMASTER United States Postal Service OFFICIAL MAIL FORWARDING CHANGE OF ADDRESS ORDER OFFICIAL USE ONLY Please PRINT items in 1-10 in blue or black ink. Your signature is required in item 9. 1. Change of Address for Individual item 5 3. Start Date ex. 02/27/08 Entire Family item 5 Business item 6 2. Is This Move Temporary M M D D Y Y 4. If TEMPORARY move print date to discontinue forwarding ex. 03/27/08 Zone /Route ID No* Yes No Date Entered on Form 3982 M M D D Y Y M D Y Expiration Date 5a* LAST Name Jr. /Sr. /Etc* 5b. FIRST Clerk/Carrier Endorsement Name and MI 6. If BUSINESS Move Print Business Name PRINT OLD MAILING ADDRESS BELOW HOUSE/BUILDING NUMBER AND STREET NAME INCLUDE ST. AVE* CT. ETC. OR PO BOX 7a* OLD Mailing Address APT or Suite 7b. For Puerto Rico Only If address is in PR print urbanization name if appropriate. CITY 7d. State 7e. ZIP PRINT NEW MAILING ADDRESS BELOW HOUSE/BUILDING NUMBER AND STREET NAME INCLUDE ST. AVE* CT. ETC. OR PO BOX 8a* NEW APT/Ste or PMB 8d. 9. Print and Sign Name see conditions below Print M M D 8e. Anyone submitting false or inaccurate information on this form is subject to punishment by fine or imprisonment or both under Section 2 1001 1702 and 1708 of Title 18 United States Code. PRIVACY NOTICE The information you provide will be used to forward your mail to a new location* Collection is authorized by 39 USC 404. Filing this form is voluntary but we cannot forward your mail without it. We do not disclose your information except in the following limited circumstances to government agencies or bodies as required to perform official duties to mailers only if they already possess your old address in legal proceedings or for service of process to law enforcement as needed for a criminal investigation or to contractors who help fulfill the service. If mailing the form below put in envelope and address as follows Remember to apply First Class postage TO POSTMASTER United States Postal Service OFFICIAL MAIL FORWARDING CHANGE OF ADDRESS ORDER OFFICIAL USE ONLY Please PRINT items in 1-10 in blue or black ink. Your signature is required in item 9. 1. Change of Address for Individual item 5 3. Start Date ex. 02/27/08 Entire Family item 5 Business item 6 2. Your signature is required in item 9. 1. Change of Address for Individual item 5 3. Start Date ex. 02/27/08 Entire Family item 5 Business item 6 2. Is This Move Temporary M M D D Y Y 4. If TEMPORARY move print date to discontinue forwarding ex. 03/27/08 Zone /Route ID No* Yes No Date Entered on Form 3982 M M D D Y Y M D Y Expiration Date 5a* LAST Name Jr. Is This Move Temporary M M D D Y Y 4. If TEMPORARY move print date to discontinue forwarding ex. 03/27/08 Zone /Route ID No* Yes No Date Entered on Form 3982 M M D D Y Y M D Y Expiration Date 5a* LAST Name Jr. /Sr. /Etc* 5b. FIRST Clerk/Carrier Endorsement Name and MI 6. If BUSINESS Move Print Business Name PRINT OLD MAILING ADDRESS BELOW HOUSE/BUILDING NUMBER AND STREET NAME INCLUDE ST. .

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