SAMPLE - USPS
Declaration by ADDRESSEE: I have received the parcel described on this note. ADDRESSEE S Signature and Date 14. Importer’s Reference - Optional (If any) 13. Sender’s Customs Reference (If any) 9. If non-deliverable: Treat as Abandoned Return to Sender Redirect to Address Below 7. Total Gross Wt: (all itemsDangerous Lbs. Ozs.) 8. Total Value ...
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