ps4205

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posted:
10/31/2007
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Delivery Type File

Order Form



1



Customer Shipping Information



Attention:



Company:



Complete Street Address, PO Box, or Rural Hwy Contract Route and Box #:



Apt/Suite #:



City:



State:



ZIP+4® Code:



Foreign Country (If applicable):



Foreign Postal Code (If applicable):



Phone Number:



Fax Number:



Email Address (Required for Web download):



2



Pricing Internet via RIBBS = $50.00 per year

(file updated monthly)



3



Payment Method



Make check or money order payable to “United States Postal Service®”



Check Discover Credit Card #



Money Order Diners Club



Visa MasterCard American Express



Send payment & order form to: ACCOUNTS RECEIVABLE NATIONAL CUSTOMER SUPPORT CENTER UNITED STATES POSTAL SERVICE 6060 PRIMACY PKWY STE 201 MEMPHIS TN 38188-0001 FAX: 901-681-4409



Card expiration date: ____ /____

Authorized Personnel (please print)



T.I.N.:__________________



Signature



For questions regarding the Delivery Type Product, please call 1-800-238-3150.

PS Form 4205, October 2003



The signature above accepts total responsibility governing the use of this card and agrees to comply with the terms of the issuer.




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