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For Everyone
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Box 1:
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Enter date
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Box 2:
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Name in Which Applicant's Mail Will Be Received for Delivery to Agent
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Box 3:
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Enter your mailing address provided by your mail forwarding
service
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Box 4:
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Enter the mailing address of your mail forwarding agent
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Box 5:
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Enter 'Yes' if you want the agent to accept registered
mail for you
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Box 6:
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Enter your name
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Box 7:
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Enter your address and phone number
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Box 8:
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Enter the number of your 2 types of identification. Make
copies of those identifications to send with your form.
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For Businesses
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Box 9:
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Enter your company name
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Box 10:
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Enter your company's address and phone number
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Box 11:
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Enter the type of business
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Box 12:
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For the business, enter the names of the people who will
receive mail
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Box 13:
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Enter the names and addresses of the company officers
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Box 14:
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Enter the registered business name and address, plus the
country, state and date of registration
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For Everyone
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Box 15:
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Get the form signed by agent or notary public
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Box 16:
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Your signature
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Since the service is required to have the originals, send
the completed form, along with the copies of your identification
to your mail forwarding service.
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