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Get USPS Combined NCOALink Processing Acknowledgement Form

COMBINED NCOALink PROCESSING ACKNOWLEDGEMENT FORM The collection of information on this Processing Acknowledgement Form PAF is required by the Privacy Act of 1974. The United States Postal Service Link Licensee have a completed NCOA PAF for each of their NCOA customers prior to providing the NCOA USPS requires that each NCOA service. The United States Postal Service Link Licensee have a completed NCOA PAF for each of their NCOA customers prior to providing the NCOA USPS requires that each NCOA service. The Licensee is also required by the USPS to retain a copy of the completed form for each of its customers and to obtain an updated PAF from each of its customers at minimum once per year. COMBINED NCOALink PROCESSING ACKNOWLEDGEMENT FORM The collection of information on this Processing Acknowledgement Form PAF is required by the Privacy Act of 1974. The United States Postal Service Link Licensee have a completed NCOA PAF for each of their NCOA customers prior to providing the NCOA USPS requires that each NCOA service. The Licensee is also required by the USPS to retain a copy of the completed form for each of its customers and to obtain an updated PAF from each of its customers at minimum once per year. Any signature upon this PAF shall be considered valid for all purposes and have the same effect whether it is an ink-signed original or a photocopy or facsimile representation of the original document. LIST OWNER I the undersigned an authorized representative of Company Name Address City Telephone Number State NAICS USPS Mailer ID ZIP 4 E-mail Address Parent Company Name Marketing or DBA Company Name or Primary Affiliate Company Name Name Please print Title Signature Date do hereby acknowledge that I have received and reviewed the NCOALink Information Package supplied to me by an NCOALink Full Service Provider Licensee and an NCOALink Limited Service Provider Licensee. I further Limited Service Provider NCOALink services may be provided by either of these understand that through an agreement with the NCOA Licensees. I also understand that the sole purpose of the NCOALink service is to provide a mailing list correction service for lists that will be used for preparation of mailings. Furthermore I understand that NCOA may not be used to create or maintain new movers lists. FULL SERVICE NCOALink LICENSEE Business Name Please print Fax Number LIMITED SERVICE NCOA LICENSEE AND BROKER LIST ADMINISTRATOR TO FULL SERVICE NCOALink For Licensee Use Only FSP PAF ID FSP Broker/Agent ID FSP List Administrator ID. The Licensee is also required by the USPS to retain a copy of the completed form for each of its customers and to obtain an updated PAF from each of its customers at minimum once per year. Any signature upon this PAF shall be considered valid for all purposes and have the same effect whether it is an ink-signed original or a photocopy or facsimile representation of the original document. Any signature upon this PAF shall be considered valid for all purposes and have the same effect whether it is an ink-signed original or a photocopy or facsimile representation of the original document. LIST OWNER I the undersigned an authorized representative of Company Name Address City Telephone Number State NAICS USPS Mailer ID ZIP 4 E-mail Address Parent Company Name Marketing or DBA Company Name or Primary Affiliate Company Name Name Please print Title Signature Date do hereby acknowledge that I have received and reviewed the NCOALink Information Package supplied to me by an NCOALink Full Service Provider Licensee and an NCOALink Limited Service Provider Licensee. .

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