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Get PS 3801 2011-2022

This notation is to be made on the part of the form for signatures of authorized agent. NOTE Unknown signatures must be identified. Signature of Clerk Verifying Customer s Signature Date SIGNATURES OF AUTHORIZED AGENTS PS Form 3801 June 2011 STANDING DELIVERY ORDER. Name and Address of Firm or Individual Include Apt. /Suite No* By Signature and title of person signing order Telephone No* The above-named firm or individual hereby authorizes representative whose signatures appears below to receive Adult Signature Required Certified Insured C. O. D Express Mail Signature Confirmation unrestricted Registered Mail and special delivery Mail addressed to or in care of the above-named firm or individual until otherwise notified in writing and assumes all responsibility for loss rifling or damage of said mail after proper delivery. All previous orders are hereby revoked* SPECIAL INSTRUCTIONS Where Restricted Delivery and/or Adult Signature Restricted Delivery mail are included the statement This authorization is extended to include Restricted Delivery and/or Adult Signature Restricted Delivery mail must be entered on the delivery order by the person signing it. Name and Address of Firm or Individual Include Apt. /Suite No* By Signature and title of person signing order Telephone No* The above-named firm or individual hereby authorizes representative whose signatures appears below to receive Adult Signature Required Certified Insured C. O. D Express Mail Signature Confirmation unrestricted Registered Mail and special delivery Mail addressed to or in care of the above-named firm or individual until otherwise notified in writing and assumes all responsibility for loss rifling or damage of said mail after proper delivery. O. D Express Mail Signature Confirmation unrestricted Registered Mail and special delivery Mail addressed to or in care of the above-named firm or individual until otherwise notified in writing and assumes all responsibility for loss rifling or damage of said mail after proper delivery. All previous orders are hereby revoked* SPECIAL INSTRUCTIONS Where Restricted Delivery and/or Adult Signature Restricted Delivery mail are included the statement This authorization is extended to include Restricted Delivery and/or Adult Signature Restricted Delivery mail must be entered on the delivery order by the person signing it. Name and Address of Firm or Individual Include Apt. /Suite No* By Signature and title of person signing order Telephone No* The above-named firm or individual hereby authorizes representative whose signatures appears below to receive Adult Signature Required Certified Insured C. O. D Express Mail Signature Confirmation unrestricted Registered Mail and special delivery Mail addressed to or in care of the above-named firm or individual until otherwise notified in writing and assumes all responsibility for loss rifling or damage of said mail after proper delivery. All previous orders are hereby revoked* SPECIAL INSTRUCTIONS Where Restricted Delivery and/or Adult Signature Restricted Delivery mail are included the statement This authorization is extended to include Restricted Delivery and/or Adult Signature Restricted Delivery mail must be entered on the delivery order by the person signing it. .

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