Instructions for USPS Form 1583

Filling In The Form - We have pre-populated this form with the

information you submitted on your application.
If you will use your mailbox for mail addressed to you as an individual, the necessary name and address fields 1 through 7 are
already complete. The remaining minimum required boxes are 8, 15, and 16. Continue reading for details.

Optional - For Businesses: If you wish to receive mail in the name of a business, fill out boxes 9 through 11 with your business
details, and optionally box 12 with the names of other members of your business. Review boxes 13 and 14 to determine if they
apply to your business.

Optional - For Spouses: Spouses may share a single Form 1583. Print the names of both spouses in box 2. Each spouse needs two
forms of ID recorded in box 8, and each spouse must provide a notarized signature in box 16.

Forms of Identification
When you present this form to a notary, they will ask to see two forms of identification as required for box 8 on the form. One
ID must contain a photograph of the applicant. The address shown on at least one of the two IDs must match the Applicant
Home Address provided in box 7.

Acceptable ID includes valid driver's license or state non-driver's identification card; armed forces, government, university, or
recognized corporate identification card; passport, alien registration card or certificate of naturalization; current lease, mortgage
or Deed of Trust; voter or vehicle registration card; or a home or vehicle insurance policy.

Unacceptable ID includes Social Security cards, credit cards, and birth certificates.

Getting It Notarized
The notary will populate boxes 8a and 8b with your ID numbers, or verify that you have done so. You will sign box 16 in their
presence, and they will sign box 15.

You may choose to visit a local notary in your area, or for immediate service use our online notary at
https://www.anytimemailbox.com/online-notary. Open 24/7, this convenient service lets you have your document notarized
online in minutes!

Returning The Form

If you used our online notary, our notary partner will return the completed form to us automatically.

If you had the form notarized locally, you will need to return the form to us. Please scan or take a clear digital photo of the
notarized form and your two forms of ID. Then log in to your account at https://www.anytimemailbox.com/login and click the
button marked Upload Notarized USPS Form 1583.

Upon submission, we will review your 1583, and if all looks well, your digital mailbox will be ready to receive mail within one
business day.

Need help? Give us a call at 1-866-444-8417 Rev. 2016-10

United States Postal Service®
Application for Delivery of Mail Through Agent 1. Date
See Privacy Act Statement on Reverse January 11, 2023

In consideration of delivery of my or our (firm) mail to the agent named below, the addressee and agent agree: (1) the addressee or the
agent must not file a change of address order with the Postal Service™ upon termination of the agency relationship; (2) the transfer of
mail to another address is the responsibility of the addressee and the agent; (3) all mail delivered to the agency under this authorization
must be prepaid with new postage when redeposited in the mails; (4) upon request the agent must provide to the Postal Service all
addresses to which the agency transfers mail; and (5) when any information required on this form changes or becomes obsolete, the
addressee(s) must file a revised application with the Commercial Mail Receiving Agency (CMRA).
NOTE: The applicant must execute this form in duplicate in the presence of the agent, his or her authorized employee, or a notary public.
The agent provides the original completed signed PS Form 1583 to the Postal Service and retains a duplicate completed signed copy at
the CMRA business location. The CMRA copy of PS Form PS 1583 must at all times be available for examination by the postmaster (or
designee) and the Postal Inspection Service. The addressee and the agent agree to comply with all applicable Postal Service rules and
regulations relative to delivery of mail through an agent. Failure to comply will subject the agency to withholding of mail from delivery until
corrective action is taken.
This application may be subject to verification procedures by the Postal Service to confirm that the applicant resides or conducts business
at the home or business address listed in boxes 7 or 10, and that the identification listed in box 8 is valid.
2. Name in Which Applicant's Mail Will Be Received for Delivery to Agent. 3a.Address to be Used for Delivery (Include PMB or # sign.)
(Complete a separate PS Form 1583 for EACH applicant. Spouses may 865 NJ 33 Business, Ste 3, Unit #212
complete and sign one PS Form 1583. Two items of valid identification apply
to each spouse. Include dissimilar information for either spouse in appropriate
box.) 3b. City 3c. State 3d. ZIP + 4®
HARUTYUN BUYUKASADURYAN Freehold NJ 07728
5. This authorization is extended to include restricted delivery mail for the
4. Applicant authorizes delivery to and in care of: undersigned(s):
a. Name
Affordable Pack-N-Ship
b. Address (No.,
street, apt./ste. no.) 865 NJ 33 Business, Ste 3, #212
c. City d. State e. ZIP + 4
Freehold NJ 07728
6. Name of Applicant 7a. Applicant Home Address (No., street, apt./ste. no)
HARUTYUN BUYUKASADURYAN MEVLANA HALID ZUMRUTEVLER MAH NISA ADALAR SITESI 13-14-15 BLOK 11
8.Two types of identification are required. One must contain a photograph of 7b. City 7c. State 7d. ZIP + 4
the addressee(s). Social Security cards, credit cards, and birth certificates MALTEPE, Turkey ISTANBUL 34852
are unacceptable as identification. The agent must write in identifying
information. Subject to verification. 7e. Applicant Telephone Number (Include area code)
a. +90 5318191688
Non-driver's identification card 9. Name of Firm or Corporation
13013453022
b. 10a. Business Address (No., street, apt./ste. no)
Passport
U08376062 10b. City 10c. State 10d. ZIP + 4

Acceptable identification includes: valid driver's license or state non-driver's 10e. Business Telephone Number (Include area code)
identification card; armed forces, government, university, or recognized
corporate identification card; passport, alien registration card or certificate of
naturalization; current lease, mortgage or Deed of Trust; voter or vehicle 11. Type of Business
registration card; or a home or vehicle insurance policy. A photocopy of your
identification may be retained by agent for verification.

12. If applicant is a firm, name each member whose mail is to be delivered. (All names listed must have verifiable identification. A guardian must list the names
of minors receiving mail at their delivery address.)

13. If a CORPORATION, Give Names and Addresses of Its Officers 14. If business name (corporation or trade name) has been registered, give
name of county and state, and date of registration.

Warning: The furnishing of false or misleading information on this form or omission of material information may result in criminal sanctions (including fines and
imprisonment) and/or civil sanctions (including multiple damages and civil penalties).
15. Signature of Agent/Notary Public 16. Signature of Applicant (If firm or corporation, application must be signed
by officer. Show title.)
X
PS Form 1583, December 2004 (Page 1 of 2) (7530-01-000-9365) This form on Internet at www.usps.com®

ATMB / BoxAppId:1064089 / RntUsrSrcId:2

 Privacy 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 usps.com®.

PS Form 1583, December 2004 (Page 2 of 2) (7530-01-000-9365)