SAMPLE - USPS
Authorization to Hold MailNOTE: Complete and give to your letter carrier or mail to the post office that delivers your : Please hold mail for:Name(s)Address (Number, street, no., city, state, ZIP + 4)Beginning DateFor Post Office Use OnlyBin NumberRoute NumberDate ReceivedClerkCarrierAccumulated mailhas been picked form 8076, April 2001Resume Delivery of mail (Date)(Complete this section only if customer selected option B)CustomerSignatureEnding Date (May only be changed bythe customer in writing)We can hold your mail for a minimum of 3,but not for more than 30 will pick up all accumulated mail when Ireturn and understand that mail deliverywill not resume until I deliver all accumulated mail andresume normal delivery on the endingdate shown below.
Resume Delivery of Mail (MM/DD/YYYY) By B. Please deliver all accumulated mail and resume normal delivery on the ending date shown below. A. I will pick up all accumulated mail from my local Post Office. Instructions: Complete this form. Then, do one of the following: (1) Give to your carrier; place in a collection box; place in your mailbox
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