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PS 4232

Rural Customer Delivery Instructions (3/2010)

Download and Print the PS 4232

Request may not be processed if the form is incomplete or illegible.

Name (Last, First, MI)

Box No.

Telephone No. (include area code)

Route No.

Post Office™, State, and ZIP + 4®

House No.

Street Name

Apt. No.

We want to deliver your parcels. If your parcel does not require a signature for delivery and will
not fit in your mail receptacle, please tell us how you wish it to be handled when no one is home to
accept delivery (Check location):

Leave outside the mailbox

Leave on the porch of residence*

Leave in other location (Specify location):*

(See Privacy Act Statement on reverse. Your correct mailing address is shown below.)
Rural Customer Delivery Instructions
Previous Editions Not Usable
Enter names of people who may receive mail at your address

To avoid delay and to assure prompt delivery of all mail, please complete this form and return it to
your carrier. Enter the name of each person who may receive mail at your address in the ten spaces
provided below. Include the names of all children and/or employees. Print the full name, including
middle initial, of each individual. This information will expedite delivery of your mail.

Rural carriers maintain a supply of stamps, cards, and envelopes for sale. Additionally, your carrier
will accept Certified Mail™, Registered Mail™, insure packages, and prepare money orders.

Generally, rural carriers can extend practically all services available at a Post Office. Please purchase
a sufficient supply of stamps and affix proper postage on all outgoing mail.

And much more...