Please use black or blue ink and print within the boxes in BLOCK LETTERS.
Please leave spaces between words. Use crosses in boxes marked with an
X
Application to Alter / Cancel
Any information provided in this form is subject to the original Mail Hold/Mail Redirection terms and conditions including those relating to personal information
usage as noted in your original application.
CRN:
Please note: If you wish to change your Mail Redirection Service to a new address, use this form to cancel your existing service, then lodge a new application.
You can only extend a service which is still current. If the service has expired, you must reapply.
Office use only
Customer reference number
✘
Checklist
1. Do you wish to change your
Mail Redirection service
Mail Hold service
X
X
from the original application
Q1 Selected Redirection or Hold
Are you cancelling your service?
X
Yes
X
No
and Yes or No
Q2 Allow 3 full working days
2. Reduce finish date - allow three full working days (Mon to Fri) after lodgement for the service to finish
D D M M Y Y Y Y
Q3 Complete
Q4 Address legible
3. Extend period If you are not returning to your old address (permanent move) - service to finish after
1 month
X
3 months
X
6 months
X
12 months
X
Q5 Complete and legible
OR
If you are returning to your old address at the end of the service (temporary move) - service to finish on
D D M M Y Y Y Y
Q6 Name legible, at least one
phone number
Q7 Signed and dated
4. Mail Redirection: the address your mail is currently being redirected from
Mail Holding: the address for which mail is currently being held
Suburb
State
Postcode
Mail Redirection only: the address your mail is currently being redirected to
Suburb
State
Postcode
Country (other than Australia)
ID to include name, address
and signatory of person
lodging form
Photo ID
ID type:
ID no:
OR 2 forms of document ID
ID type:
ID no:
ID type:
ID no:
5. Add or remove names or business / organisation covered by this application
Title (Mr, Mrs etc)
Add names
Business / surname (include maiden name, if applicable)
Title (Mr, Mrs etc)
Remove names
Business / surname (include maiden name, if applicable)
Given names (in full)
Given names (in full)
6.
Details of the person lodging this form
Title (Mr, Mrs etc)
Surname (include maiden name, if applicable)
Given names (in full)
Area Area
code Daytime phone code After hours phone
Mobile phone
7.
Declaration by the person lodging this form - I have authority to include the
Signature
people listed above. I understand it is a criminal offence to have a person’s
mail held or re-directed without their authority or to give Australia Post false or
misleading information. I have read and understood the terms and conditions.
D D
Date
M M Y Y Y Y
Accepting officer’s name
If applicable, document sighted
X
X
Pension
X
X
Written authority
card
Business reg docs
Stat dec
Charge category
Service delivery
Business
Other
Box diversion
Concession
Deceased estate
Staff
Bankruptcy
trustee
Amount Paid $
Attach receipt to customer copy
and attach copy of receipt to the
back of the LH corner of this sheet
(not on the barcode corner)
Advise customer to keep copy/CRN
DATE STAMP
click to sign
signature
click to edit
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