Collection of this information is authorized by 39 USC 403 and
404. This information will be used to authorize the delivery of the intended
addressee's mail to another. The Postal Service may disclose this information
to an appropriate government agency, domestic or foreign, for law enforcement
purposes; where pertinent, in a legal proceeding to which the Postal Service is
a party or has an interest; to a government agency in order to obtain
information relevant to a USPS decision concerning employment, security
clearances, contracts, licenses, grants, or other benefits; to a congressional
office at your request; to an expert, consultant, or other person under
contract to the USPS to fulfill an agency function; to the Federal Records
Center for storage; to the Office of Management and Budget for review of
private relief legislation; to and independent certified public accountant
during an official audit of USPS finances; to a labor organization as required
by the National Labor Relations Act; for the purpose of identifying an address
as an address of an agent to whom mail is delivered on the behalf of other
persons; and to anyone when the delivery address is being used for the purpose
of doing or soliciting business with the public. Completion of this form is
voluntary; however, without the information, the mail will be withheld from
delivery to the agent and delivered to the addressee, or, if the address of the
addressee is that of the agent, returned to sender.
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