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

Please PRINT items in 1-10 in blue or black ink. Your signature is required in item 9.

      • M M
      • D D
      • Y Y
      • change-of-address-pdf
      OFFICIAL USE ONLY
      Zone/Route ID No.
      Date Entered on From 3982
      M
      M
      D
      D
      Y
      Y
      Expiration Date
      M
      M
      D
      D
      Y
      Y
      Clerk/Carrier Endorsement
      PRINT OLD MAILING ADDRESS BELOW: HOUSE/BUILDING NUMBER AND STREET NAME (INCLUDE ST.,AVE.,CT., ETC) OR PO BOX
      PRINT NEW MAILING ADDRESS BELOW: HOUSE/BUILDING NUMBER AND STREET NAME (INCLUDE ST.,AVE.,CT., ETC) OR PO BOX
      • Print:
      • Sign:
      (ex. 01/27/08)

      MMDDYY

      OFFICIAL USE ONLY

      PS FORM 3575 MAY 2008 Visit USPS.com to change your address online or call 1-800-ASK-USPS (1-800-275-8777) 0508

      NOTE: The person singing 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. 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.

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