Ps Form 1583 - Application For Delivery Of Mail Through Agent - Usps Page 2
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2Privacy Act Statement: Your information will be used to authorize the delivery of your mail to the designated
addressee as your agent. Collection is authorized by 39 USC 401, 403, and 404. Providing the information is
voluntary, but if not provided, we cannot provide this service to you. We do not disclose your information without your
consent to third parties, except for the following limited circumstances: to a congressional office on your behalf; to
financial entities regarding financial transaction issues; to a USPS ® auditor; to entities, including law enforcement, as
required by law or in legal proceedings; to contractors and other entities aiding us to fulfill the service; and for the
purpose of identifying an address as an address of an agent who receives mail on behalf of other persons. Information
concerning an individual who has filed an appropriate protective court order with the postmaster will not be disclosed
except pursuant to court order. For more information on our privacy policies, see our privacy link on ® .
1583,
PS Form
December 2004 (Page 2 of 2) (7530-01-000-9365)
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Parent category: Life