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HOW TO APPLY FOR A PO BOXMany people have discovered that Post Ofce Box service is a sae,

convenient way to receive their mail. Learn all about PO Box service

on the frst two pages o this orm. Then, decide whether to apply

online or at a Post Ofce.

SELECT a O BOX SIZEAcross the U.S., Postal Service PO Boxes are available in fve sizes.

However, not all Post Ofce locations have every size. Be sure to

elect the right size or your mail volume and schedule.

Our smallest box (Size 1) fts 1015 letter-sized envelopes or up to

wo rolled magazines. Start with a Size 2 box i you receive more than

5 mailpieces a week. Size 3, 4, or 5 is recommended i you receive

magazines and catalogs.

Size 1:

3" X 5.5"

Size 4:

11" X 11"

Size 2:

5" X 5.5"

Size 3:

11" X 5.5"

Size 5:

22.5" X 12"

ts easy to fnd a box thats right or you. Find an available PO Box by

going to www.yourotheraddress.com.

you need more room than our largest box provides, ask at your local

Post Ofce about Business Mail Pickup (Caller) Service.

FEESTo fnd a PO Box in your area and get ee inormation, visit

www.yourotheraddress.com. You may pay your initial PO Box ees

online or at a Post Ofce.

THERE aRE TWO SIMLE WaYSTO aLYapply online: Complete the online application at

www.usps.com/poboxesand make your frst payment with a credit

or debit card. (Online registration is not available or Business Mail

Pickup (Caller) Service or Qualiying No-Fee box customers.)

apply t ost Ofce: Complete pages 3 and 4 and take this

whole orm to a Post Ofce most convenient or you. Once we veriy

your inormation and receive your payment, we will provide your

PO Box address and begin your service.

Id REQUIREdWhether you apply online or at a Post Ofce,two vli forms

of ientiction are required when you obtain your keys or

combination at the Post Ofce where your box is located. You mu

present the IDs at a Post Ofce. One item must contain a photogand one must be traceable to the bearer ( prove your physical

address). Both must be current. Acceptable orms o ID include:

hoto Id Options:

Valid drivers license or state non-drivers identifcation card

Armed orces, government, university, or recognized corporate

identifcation card

Passport, passport card, alien registration card, or certifcate

naturalization

on-hoto Id Options:

Current lease, mortgage, or deed o trust

Voter or vehicle registration card

Home or vehicle insurance policy

ote: Social Security cards, credit cards, and birth certifcates a

not acceptable orms o ID.

REEWaL aYMETSRenewal payments are due the last day o the month your service

period ends. I your payment is late, you will not be able to acces

the mail in your box. Ater 10 days o nonpayment, we remove th

mail, treat it as undeliverable, and close your box. You may alsoincur a late payment ee. Note that closed PO Boxes are available

or new customers immediately, so late payment can lead to loss

your PO Box address. You may renew your PO Box online, at a Po

Ofce, by mail, or at an Automated Postal Center (APC). It is y

responsibility to pay your renewal ee on time. Convenient payme

options are:

y online: Use a valid credit or debit card to make a one-time

payment or set up automatic renewal payments at

www.usps.com/poboxes.

y in person: Pay at the Post Ofce where your PO Box is loca

using cash, check, credit card, or debit card, or set up automatic

renewal payments (available at most Post Ofces) . Automatic ren

payment is required or 3-month payment option.

y t ny automte ostl Center (aC): Find an APC at

www.usps.com/locatoror by downloading the mobile application

www.usps.com/mobile.

y by mil: Send a check or money order (payable to U.S. Po

Service) to the postmaster, city, state, and ZIP Code where you

PO Box is located. Payments by mail must be received by the due

date. (Do not send cash by mail.)

PS Form 1093, January 2012 (Page 1 of 4) PSN 7530-02-000-7165. See our Privacy Act Statement on page 4 of this form.

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TERMS OF SERVICEThe terms o service are defned exclusively by postal regulations.

You may not use PO Box service just to avoid paying orwarding

charges or or any purpose prohibited by law or Postal Service

egulations. We will immediately terminate PO Box service i used

or any unlawul purpose. PO Box service may be provided to minors

unless parents or guardians submit a written objection to the

postmaster).

UdaTI YOUR IFORMaTIOThe inormation on your PS Form 1093 must always be current.As soon as any inormation changes (such as your street address,

elephone number, or email address), you are responsible or updating

he inormation. Failure to update your inormation may result in

ermination o service. We keep the orm on fle at the Post Ofce

where you use the service.

aCCUMULaTEd MaILWe encourage you to empty your box regularly. You can make a

special arrangement with the postmaster i you are not able to pick

up your mail. Complete PS Form 8076,Authorization to Hold Mail, or

create your request online at usps.com, and well take care o it. Hold

Mail orders are good or only 30 days. I the volume o your incoming

mail repeatedly exceeds the capacity o the box you are using, we

may require that you use Business Pickup (Caller) Service, change to

a larger box (and pay the applicable ees), or apply or one or more

additional boxes. Your service may also be suspended. You may also

equest remium Forwring Service to have your mail shipped

o you by Priority Mail service once a week or a small ee.

CHaE OF addRESS you choose to discontinue your PO Box service, please complete

a change o address orm ound in the Movers Guide availableby request rom our retail associates or on our website at

www.usps.com/moversguide. I you use the change o address orm,

give it to a retail associate or your letter carrier. You may also mail the

orm to your Post Ofce. File change o address orders as ollows:

o-Fee O Boxes: The PO Box customer or any other person listed

on the PS Form 1093 may fle an individual change o address order.

Only the box customer may fle a change o address order or an

entire amily.

all other O Boxes: Only the box customer who signs the

PS Form 1093 may fle change o address orders. Forwarding o mail

or other persons receiving mail at the box is the responsibility o the

box customer.

O BOX KEYSTwo keys are issued or key-type PO Boxes. An access code is

provided or combination lock-type PO Boxes. At most locations, a

reundable deposit is required or each key. I needed, you can obt

additional keys (and pay the applicable ee and deposit). Wheneve

your box service terminates, return all keys to the Postal Service o

reund o the deposit. Customers must not duplicate PO Box keys.

O BOX REFUdS

Once you have begun using your PO Box, you may request a reunat the Post Ofce where your box is located. Fees are reunded as

ollows:

3-Month yments (utomtic renewl require):

No reunds

6-Month yments:

Within the frst 3 months the ee paid

Ater 3 months no reunds

12-Month yments:

Within the frst 3 months the ee paid

Within the frst 6 months the ee paidWithin the frst 9 months the ee paid

Ater 9 months no reunds

BOX SERVICE addRESSWe deliver to your PO Box address as printed on your mail, so be

sure to provide correct and current address inormation to your

correspondents.

Your PO Box number should appear on a separate line, ollowed by

the Post Ofces city, state, and ZIP+4. When we assign your box

number, we will provide the corresponding ZIP+4 code.

For Ofcil Use: Complete by the ostl Service

YOUR EW BOX UMBER IS

CITY

STaTE

YOUR ZI+4 IS

HOW TO USE THE COMBIaTIO LOCK

1. Clear the dial by turning RIHT three times and stop on _____

2. Turn LEFT and stop the second time around on _____

3. Turn RIHT and stop on _____

4. Turn the latch key LEFT to open

PS Form 1093, January 2012 (Page 2 of 4) 7530-02-000-7165. See our Privacy Act Statement on page 4 of this form.

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Box umber(s) _________________________

appliction for ost Ofce Box ServiceFill out all non-shaded felds, and take this application to the Post Ofce.

1. Thisserviceisfor(Required selection):Business/OrganizationUseResidential/PersonalUse

2. NameofBusiness/Organization (i applicable):

3. NameofPersonApplying(Last, First, MI include title if representing a business/organization):

4. Address:Number,Street,Suite____________________________________________________________________________________

___________________________________________________________________________________________________________

City_____________________________________________________________State__________ZIP+4______________________

Verifyinitia

5. TelephoneNumber(Include Area Code) 6. EmailAddress

7. BoxSize(s)(Required)See page 1 or detailsSize1Size2Size3Size4Size5

8. ApplicantmustselectandentertheIDNumberfortwoitemsofvalididenticationlistedbelow.YoumustpresenttheIDsataPostOfce.Oneitemmustcontaina

photographandonemustbetraceabletothebearer(proveyourphysicaladdress).Bothmustbecurrent.Select one photo Id: Select one non-photo Id:

Validdriverslicenseorstatenon-driversIDcard Currentlease,mortgage,ordeedoftrust

Armedforces,government,university,orrecognizedcorporateID Voterorvehicleregistrationcard

Passport,passportcard,alienregistrationcard,orcerticateofnaturalization Homeorvehicleinsurancepolicy

hoto Id umber: _________________________________ on-hoto Id umber: ________________________________

Verifyinitials(ForPostOfceUseOnly)_____________

9. Ontheback of this form,listthename(s)ofallindividuals,includingmembersofabusiness,whowillbereceivingmailatthis(these)POBoxnumber(s).

10. Ontheback of this form,listthenamesofthepersonsorrepresentativesofthebusiness/organizationauthorizedtopickupmailaddressedtothis(these)

POBoxnumber(s).

Optionl automtic Renewl yment Terms n agreement (Require for 3-month pyment option)ByinitialingbelowandestablishingautomaticrenewalpaymentsataPostOfce,IherebyauthorizetheU.S.PostalService(USPS)tochargemycreditcardfortheamountofmy

designatedboxsizeperUSPSpricingonthescheduledintervalIhaveselected(i.e.,3,6,or12months).Thischargecouldappearonmycreditcardstatementasearlyasthe15thof

themonthpriortotheduedate.IfIprovidedmyemailaddress,IunderstandthatIwillreceiveemailnoticationatleast10dayspriortotheactualcreditcardcharge.Iwillalsoreceive

apaymentduenoticeinmyPOBoxbeforethepaymentduedate.IunderstandthatImaycanceltheautomaticpaymentoptionanytimeaftertheinitialapplication/paymentprocessis

completeduringthebusinesshoursatthePostOfcewheremyboxislocated.IfIdonotcancelbythe14thofthemonthpriortothenextpaymentduedate,Iunderstandthatthepay

willbechargedtomycreditcard.Iunderstandthatifthepaymentcannotbetransactedduetoincorrectorobsoletepaymentinformationorthetransactionwouldexceedthecreditlim

oftheaccount,orthebankorcreditcardcompanyrejects/returnsthepaymentrequest,myPOBoxmaybeclosedandanymailreceivedafterclosurewouldbereturnedtothesender.

myPOBoxisclosedfornonpayment,IunderstandthatIcouldbechargedalatepaymentfeetoreactivatemyPOBoxservice.Ifthereareanychangestomycreditcardnumber,billing

address,orexpirationdate,IagreetonotifythePostOfcewheremyboxislocatedofthesechanges.IunderstandthatthisagreementwillremainineffectuntilIorUSPSterminatest

POBoxservice.TheUSPSmayreceiveupdatedcreditcardaccountinformationfromtheinstitutionthatissuedthecardidentiedforpayment.IfIdecidetoclosemyPOBox,Imustvis

thePostOfcewheremyboxislocatedduringbusinesshours.(SeethePOBoxrefundpolicyforinformationonrefunds.)TheUSPSmayterminatemyparticipationunderthisautomati

paymentagreementintheeventIprovideincorrect,false,orfraudulentaccountinformationorifIhaveanyreturnedpaymentitems.

Customer Initils _______ Billing aress(if different from address in 4 above):

Number,Street,Suite___________________________________________________________________________________________________________

City__________________________________________________________________________State__________ZIP+4 _________________________

ApplicationDate NumberofKeys

Issued

_______________

CustomerEligibleforNo-FeeService

Yes No

PostOfceDateStamp

Signature of Applicant (Same as item 3)I certify that all information furnished on this form is accurate,truthful, and complete. I understand that anyone who furnishes false or misleading information on this form

or omits information requested on this form may be subject to criminal and/or civil penalties, including

nes and imprisonment.

_______________________________________________________________________________________________S Form 1093, January 2012 (Page 3 of 4) 7530-02-000-7165. See our Privacy Act Statement on page 4 of this form.

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appliction for ost Ofce Box ServiceThe Postal Service may consider it valid evidence that a person is authorized to remove mail rom the box i that person possesses a key or

combination to the box.

11. Namesofindividuals(includingmembersofabusiness)whowillbereceiving

mailatthis(these)POBoxnumber(s)arelistedbelow.

a. Resientil/ersonl Use Eachadultlistedmustpresenttwoformsof

valididenticationtothePostOfce.

b. Business/Orgniztion Use Eachpersonlistedmust,uponrequest,

presenttwoformsofvalididenticationtothePostOfce.

Aparentorguardianmayreceivethemailofminorsbylistingtheirnames(noIDisrequired).

12. Personsorrepresentativesofthebusiness/organizationwhoareauthorized

topickupmailaddressedtothis(these)POBoxnumber(s)arelistedbelow

AllnameslistedmusthaveveriableIDanduponrequest,presentthis

identicationtothePostalService.

Verifyinitials(forPostOfceUseOnly)_________ Verifyinitials(forPostOfceUseOnly)________

2011 United States Postal Service. All Rights Reserved. The Eagle Logo, PO Box and Your Other Address are some of the many trademarks of the U.S. Postal Service .

PS Form 1093, January 2012 (Page 4 of 4) PSN 7530-02-000-7165

rivcy act Sttement:YourinformationwillbeusedtoprovidePostOfceBox service

ndtoensuredeliverytothebox.Collectionisauthorizedby39U.S.C.401,403,and404.

Providingtheinformationisvoluntary;but,ifnotprovided,wewillbeunabletoprovidethis

ervicetoyou.Wedonotdiscloseyourinformationtothirdpartieswithoutyourconsent,

xcepttofacilitatethetransaction,toactonyourbehalforrequest,oraslegallyrequired.

Thisincludesthefollowinglimitedcircumstances:toacongressionalofceonyourbehalf;to

nancialentitiesregardingnancialtransactionissues;toaU.S.PostalService auditor;to

entities,includinglawenforcement,asrequiredbylaworinlegalproceedings;tocontrac

andotherentitiesaidingustofullltheservice(serviceproviders);toprocessservers;to

domesticgovernmentagenciesifneededaspartoftheirduties;andtoaforeigngovernm

agencyforviolationsandallegedviolationsoflaw.Informationconcerninganindividualb

holderwhohasledaprotectivecourtorderwiththepostmasterwillnotbedisclosedexc

pursuanttocourtorder.Formoreinformationregardingourprivacypolicies,

visitusps.com/privacypolicy.