United States Postal Service
Application to Act as a Commercial Mail Receiving Agency
1. Date
TO: POSTMASTER
In registering wit
h the Postal Service to act as an agency to receive delivery of mail of others, the agent agrees to the
following: (1) the Commercial Mail Receiving Agency (CMRA) must have on file a Form 1583, Application for Delivery
of Mail Through Agent, for each addressee or firm receiving mail at the agency; (2) a CMRA must represent its
delivery address as a private mailbox; (3) the CMRA is not authorized to accept Registered Mail from their clients for
mailing, the Post Office is the only acceptable mailing point; (4) the CMRA must be in full compliance with Domestic
Mail Manual (DMM) 508.1.8.1 through 508.1.8.4 and other applicable postal requirements to receive delivery of mail
from the Postal Service; and (5) when any information required on this form changes, the CMRA owner or manager
must file a revised application with the postmaster.
NOTE: The CMRA owner or manager must execute this form in duplicate in the presence of the postmaster or
designee. The CMRA owner or manager retains the signed duplicate copy and signs in this space
to signify receipt and understanding of applicable DMM regulations regarding delivery of mail to a CMRA by the
Postal Service. This application may be subject to verification procedures by the Postal Service to confirm that the
CMRA owner or manager resides at the permanent home address listed below, and that identification presented in
box 10 is valid. Failure to comply with DMM 508.1.8.1 through 508.1.8.4 and all other applicable Postal Service
requirements may subject the agency to withholding of mail until corrective action is taken.
2. Name of Commercial Mail Receiving Agency (CMRA) (Corporation or
Trade Name)
3. Name of CMRA Owner/Manager
4. Street Address of CMRA (Number, street, city, state, and ZIP Code) 5. P.O. Box Address of CMRA (Include city, state, and ZIP Code)
6. CMRA Telephone Number
( )
7. Permanent Home Address of CMRA Owner/Manager (Number, street,
city, state, and ZIP Code)
8. Home Telephone Number of CMRA Owner/Manager
( )
9. Agency Manager or Contact (Name and telephone number)
( )
10. Two types of identification are required. One must contain a
photograph of the CMRA owner or manager. Social Security cards,
credit cards, and birth certificates are unacceptable as identification.
The postmaster or designee must write in type of identifying
information.
a.
b.
Acceptable identification includes: valid driver's license or state non-
driver's identification card; armed forces, government, university or
recognized corporate identification card; Passport, alien registration
card or certificate of naturalization; current lease, a mortgage, or Deed
of Trust; voter or vehicle registration card; or a home or vehicle
insurance policy. A photocopy of your identification may be retained
by postmaster or designee for verification.
WARNING:
The furnishing of false or misleading information on this
form, or omission of material information, may result in criminal
sanctions (including fines and imprisonment) and/or civil sanctions
(including multiple damages and civil penalties). (18 U.S.C. 1001)
See Privacy Act Statement on Reverse
11. Signature of CMRA Owner or Manager and Date
12. Signature of Postmaster or Designee and Date
PS Form 1583-A, June 2011
This form is on the Internet at www.usps.com.
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signature
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Privacy Act Statement
Privacy Act Statement: Your information will be used to authorize
the delivery of intended addressees' mail to you as their agent.
Collection is authorized by 39 U.S.C. 401, 403, and 404.
Providing the information is voluntary, but if not provided, we cannot
provide this service to you. We do not disclose your information
without your consent to third parties, except for the following limited
circumstances: to a congressional office on your behalf; to financial
entities regarding financial transaction issues; to a U.S. Postal
Service auditor; to entities, including law enforcement, as required
by law or in legal proceedings; to contractors and other entities
aiding us to fulfill the service; and for the purpose of identifying an
address as an address of an agent who receives mail on behalf of
other persons. Information concerning an individual who has filed
an appropriate protective court order with the postmaster will not be
disclosed except pursuant to court order. For more information
regarding our privacy policies visit usps.com/privacypolicy.
PS Form 1583-A, June 2011 (Reverse)