Complete a separate Form 1583 for EACH applicant. Spouses may complete and sign one Form 1583. Two items of valid identification apply to each spouse. Include dissimilar information for either spouse in appropriate box. | |
Box (1): | Include house number, street, and apartment/suite number if applicable. |
Box (2): | For Business/Organization Use, complete item 7. |
Box (3): | For Residential/Personal Use, complete a separate PS Form 1583 for each adult using this PMB. |
Box (4): | Address must match document provided in item 9b. |
Box (5): | The Applicant authorizes mail to be collected by the individual noted in item 5. |
Box (6): | Address must match document provided in item 11b. |
Box (7): | Complete item 6 if the mail addressed to this PMB is to be transferred, mailed, shipped, or emailed to another address. |
Box (8): | The place of registration is the county and state (if domestic), or the country (if foreign). |
Box (9): | Two types of identification are required for both the Applicant and, if listed, the Authorized Individual. One ID must be a government-issued photo ID. The second must confirm the Applicant’s or Authorized Individual’s address listed on this form. The acceptable types of photo ID are listed in items 8e and 10e. Attach a copy of the photo and address ID documents. |
Box (10): | Although the driver’s/nondriver’s ID is listed in 8e and 9g as an option for both the Applicant’s photo ID and address ID, it may be used for only one of the IDs (either photo ID or address ID), not for both. |
Box (11): | The acceptable types of address verification are listed in items 9g and 11g. Attach a copy of the photo and address ID documents. |
Box (12): | Although the driver’s/nondriver’s ID is listed in 10e and 11g as an option for both the Authorized Individual’s photo ID and address ID, it may be used for only one of the IDs (either photo ID or address ID), not for both. |
Box (13): | For Business/Organization Use: List members who will be receiving mail at this PMB. Each person listed must, upon request, present two forms of valid ID to the Postal Service. For Residential/Individual Use: A parent or guardian may receive the mail of a minor by listing the minor’s name — the minor’s ID is not required. |
Box (14): | By signing this form, the applicant certifies the following — for Business/Organization Use, an officer must sign the application and provide his or her title: 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 fines and imprisonment. |
Box (15): | The agent or an authorized employee may sign item 14a. If the Notary Public box at the bottom of page 2 has a seal, the Notary Public completes the box. |
Box (16): | Signature. |
Please send the completed form with the copies of two identification documents to:
USABOX, INC.
8345 NW 66 ST
MIAMI FL 33166