U.S.P.S. Form 1583 Directions
Please read the following directions for completing the Application for Delivery of Mail Through Agent (PS Form
1583) carefully. This form must be notarized or signed in front of a representative of Saffran Packaging.
Box 1
Today's date.
Box 2
Applicant's full, legal name(s) (individual, spouse, child). Complete a separate PS Form 1583 for each additional
name receiving mail.
Box 3 (a – d)
LEAVE BLANK. Saffran Packaging will complete this area for you.
Box 4 (a – e)
LEAVE BLANK. Saffran Packaging will complete this area for you.
Box 5
Writing “YES” in this section will authorize Saffran Packaging to receive restricted mail for you. Restricted mail may
be important legal documents.
Writing “NO” will not allow Saffran Packaging to receive restricted mail for you.
Box 6
Applicant's full, legal name (the person completing the application and providing valid identification).
Box 7 ( a – e)
Applicant's actual home address and phone number.
Box 8 (a and b)
Record two forms of valid identification. Acceptable forms of identification are listed in box 8 . You will need to send
Saffran Packaging copies of the two forms of identification used.
Boxes 9 – 14 need only be completed if you will use your mailbox to receive mail under a business name. If you
will not include a business name, skip to Box 15.
Box 9
Fill in the legal name of your business if you will be operating under a business name.
Box 10 ( a – d)
Actual business address. If you operate a home-based business, then enter your home address and phone
number.
Box 11
Describe the type of business if you are planning to use this mailbox for business use (example: marketing,
graphic design, retail, etc.).
Box 12
If you are renting this box for business use, then enter all additional recipients. Mail can only be received for
individuals that have completed a PS Form 1583.
Box 13
If your business is a corporation, then list all officers of the corporation.
Box 14
Provide the county, state and date of registration if you have registered your business with a government entity.
Box 15
A notary public or representative from Saffran Packaging must sign in this box. Bring the two forms of identification
listed in box 8 upon signing.
Box 16
Signature of applicant. Sign your name in front of a notary public or representative from Saffran Packaging.
If you have any questions, please contact Saffran Packaging at (619) 222-4876. We will be more than happy to
provide you with assistance.